scholarly journals Personality disorder and the outcome of depression: Meta-analysis of published studies

2006 ◽  
Vol 188 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Giles Newton-Howes ◽  
Peter Tyrer ◽  
Tony Johnson
Keyword(s):  
Personality Disorder ◽  
Electroconvulsive Therapy ◽  
Affective Disorders ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Random Effects Model ◽  
Poor Outcome ◽  
Electronic Search ◽  
Conflicting Evidence ◽  
Made In

BackgroundThere is conflicting evidence about the influence of personality disorder on outcome in depressive disorders.AimsMeta-analysis of studies in which a categorical assessment of personality disorder or no personality disorder was made in people with depressive disorders, and categorical outcome (recovered/not recovered) also determined.MethodSystematic electronic search of the literature for relevant publications. Hand searches of Journal of Affective Disorders and recent reviews, with subsequent meta-analysis of selected studies.ResultsComorbid personality disorder with depression was associated with a doubling of the risk of a poor outcome for depression compared with no personality disorder (random effects model OR=2.18, 95% C11.70–2.80), a robust finding maintained with only Hamilton-type depression criteria at outcome (OR=2.20, 95% C11.61–3.01). All treatments apart from electroconvulsive therapy (ECT) showed this poor outcome, and the ECT group was small.ConclusionsCombined depression and personality disorder is associated with a poorer outcome than depression alone.

A Treatment Outline for Depressive Disorders

1983 ◽  
Vol 17 (2) ◽  
pp. 129-146 ◽  
Keyword(s):  
Quality Assurance ◽  
Treatment Outcome ◽  
Electroconvulsive Therapy ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Antidepressant Drugs ◽  
Endogenous Depression ◽  
Government Support ◽  
Sources Of Information ◽  
Quality Assurance Project

With College and Government support the Quality Assurance Project is developing a series of explicit and detailed treatment outlines of major psychiatric disorders for use in peer review. Three sources of information are used: a meta-analysis of the treatment outcome literature, the opinions of a sample of practising psychiatrists and the views of a panel of nominated experts. The present outline concerns the treatment of depressive disorders. The three sources of information were in agreement that tricyclic and allied antidepressants were the treatments of choice for endogenous depression and were also to be considered in persistent neurotic depressions. Electroconvulsive therapy was recommended in patients with endogenous depression who were severely ill, troubled by hallucinations and delusions or for whom the antidepressant drugs had not proven effective. The psychotherapies, both dynamic and behavioural, were regarded as the treatments of choice in neurotic depression.

The Diagnosis of Depressive Syndromes and the Prediction of E.C.T. Response

1965 ◽  
Vol 111 (477) ◽  
pp. 659-674 ◽  
Author(s):  
M. W. P. Carney ◽  
M. Roth ◽  
R. F. Garside
Keyword(s):  
Clinical Practice ◽  
Personality Disorder ◽  
Affective Disorders ◽  
Mental Hospital ◽  
Clinical Stage ◽  
Large Contribution ◽  
Depressive Syndromes ◽  
Overall Reliability ◽  
Made In

The establishment of a classification of affective disorders commanding wide agreement among clinical practitioners and investigators is one of the most pressing needs of contemporary psychiatry. This group of conditions has, in recent decades, displaced schizophrenia from the centre of the clinical stage. However, despite its prominence and importance in clinical practice, the territory remains inadequately charted. There is evidence to indicate that the uncertainty about the most clear and convenient lines of demarcation within this clinical territory makes a large contribution to the unreliability of psychiatric diagnosis. Thus, in a recent enquiry (Sandifer, Pettus and Quade, 1965) into the reliability of diagnoses made in 91 first admissions to a mental hospital by ten experienced psychiatrists, it was shown that the resolution of disagreement in the areas of “psychoneurosis—affective disorder” and “psychoneurosis—personality disorder” would have raised the overall reliability of diagnosis in this enquiry from 57 per cent. to 83 per cent.

scholarly journals Use of isotretinoin and risk of depression in patients with acne: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e021549 ◽  
Author(s):  
Changqiang Li ◽  
Jianmei Chen ◽  
Wo Wang ◽  
Ming Ai ◽  
Qi Zhang ◽  
...  
Keyword(s):  
Depressive Disorders ◽  
Retrospective Studies ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Depression Symptoms ◽  
Random Effects Model ◽  
Data Synthesis ◽  
Pooled Data ◽  
Randomised Controlled ◽  
The Cochrane Library

ObjectiveThis study aimed to investigate the association between the use of isotretinoin and the risk of depression in patients with acne.DesignThis was a meta-analysis in which the standardised mean difference (SMD) and the relative risk (RR) were used for data synthesis employing the random-effects model.SettingStudies were identified via electronic searches of PubMed, Embase and the Cochrane Library from inception up to 28 December 2017.ParticipantsPatients with acne.InterventionsStudies comparing isotretinoin with other interventions in patients with acne were included.ResultsTwenty studies were selected. The analysis of 17 studies showed a significant association of the use of isotretinoin with improved symptoms compared with the baseline before treatment (SMD = −0.33, 95% CI −0.51 to −0.15, p<0.05;I2=76.6%, p<0.05)). Four studies were related to the analysis of the risk of depression. The pooled data indicated no association of the use of isotretinoin with the risk of depressive disorders (RR=1.15, 95% CI 0.60 to 2.21, p=0.14). The association of the use of isotretinoin with the risk of depressive disorders was statistically significant on pooling retrospective studies (RR=1.39, 95% CI 1.05 to 1.84, p=0.02), but this association was not evident on pooling prospective studies (RR=0.85, 95% CI 0.60 to 2.21, p=0.86).ConclusionsThis study suggested an association of the use of isotretinoin in patients with acne with significantly improved depression symptoms. Future randomised controlled trials are needed to verify the present findings.

scholarly journals Heterogeneity Signs on Noncontrast Computed Tomography Predict Hematoma Expansion after Intracerebral Hemorrhage: A Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Danfeng Zhang ◽  
Jigang Chen ◽  
Qiang Xue ◽  
Bingying Du ◽  
Ya Li ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Intracerebral Hemorrhage ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Hematoma Expansion ◽  
Random Effects Model ◽  
Poor Outcome ◽  
Increased Risk ◽  
Noncontrast Computed Tomography ◽  
Swirl Sign

Background and Purpose. Hematoma expansion (HE) is related to clinical deterioration after intracerebral hemorrhage (ICH) and noncontrast computed tomography (NCCT) signs are indicated as predictors for HE but with inconsistent conclusions. We aim to clarify the correlations of NCCT heterogeneity signs with HE by meta-analysis of related studies. Methods. PubMed, Embase, and Cochrane library were searched for eligible studies exploring the relationships between NCCT heterogeneity signs (hypodensity, mixed density, swirl sign, blend sign, and black hole sign) and HE. Poor outcome and mortality were considered as secondary outcomes. Odds ratio (OR) and its 95% confidence intervals (CIs) were selected as the effect size and combined using random effects model. Results. Fourteen studies were included, involving 3240 participants and 435 HEs. The summary results suggested statistically significant correlations of heterogeneity signs with HE (OR, 5.17; 95% CI, 3.72–7.19, P<0.001), poor outcome (OR, 3.60; 95% CI, 1.98–6.54, P<0.001), and mortality (OR, 4.64; 95%, 2.96–7.27, P<0.001). Conclusions. Our findings suggested that hematoma heterogeneity signs on NCCT were positively associated with the increased risk of HE, poor outcome, and mortality rate in ICH.

scholarly journals Association Between ABCA1 (R219K) Polymorphism and Lipid Profiles: A Meta-Analysis

2020 ◽  
Author(s):  
Zhangyan Shi ◽  
Yajie Tian ◽  
Yufei Wu ◽  
Junlin Li ◽  
Qianliang Chen ◽  
...  
Keyword(s):  
Lipid Level ◽  
Meta Analysis ◽  
Health Condition ◽  
Lipid Profiles ◽  
Random Effects Model ◽  
Asian Populations ◽  
Standard Mean Difference ◽  
Conflicting Evidence ◽  
The Difference ◽  
The Relationship

Abstract Background Conflicting evidence was found about the relationship between lipid profiles and R219K in adenosine triphosphate-binding cassette exporter A1 (ABCA1) gene. A meta-analysis was conducted to assess the effect of R219K on lipid level. Methods Multi-database literature search was performed in accordance with PRISMA guidelines. The effect of each study was expressed by standard mean difference (SMD) and 95% confidence interval and pooled by meta-analysis in a random-effects model. Sub-group and meta-regression analyses were also conducted to explore potential heterogeneity sources. Results Overall pooled effect showed that individuals with RR genotype had significantly lower HDLC level (SMD = -0.17 mmol/L, 95% CI: -0.22 ~ -0.12, z = -6.39, P < 0.001) than those with K allele. However, this effect mainly presented in Asians (SMD = -0.24 mmol/L, 95% CI: -0.32 ~ -0.17, z = 6.60, P < 0.001) rather than Caucasian populations, and the difference was significant (Q = 5.20, df = 1, P = 0.02). The relationship between R219K polymorphism and LDLC, TC, and TG levels was not determined. Conclusions R219K polymorphism in the ABCA1 gene was associated with HDLC level in Asian populations in the present meta-analysis. This correlation was not substantially affected by the age, gender or health condition of individuals.

Efficacy and Safety of Electroconvulsive Therapy in Depressive Disorders

2018 ◽  
Author(s):  
Joseph J. Taylor ◽  
Robert Ostroff
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Electroconvulsive Therapy ◽  
Clinical Case ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Safety And Efficacy ◽  
Life Saving ◽  
Basic Concepts

This chapter will summarize an important systematic review and meta-analysis. The authors of this study analyzed decades of evidence from thousands of patients in order to address fundamental questions about the safety and efficacy of electroconvulsive therapy for depressive symptoms. The data from this manuscript continue to inform clinical practice in regards to this stigmatized yet potentially life-saving treatment. The chapter will discuss the setup and implementation of the systematic review and meta-analysis before focusing on the results and their implications. The last section of the chapter will identify relevant studies and present a hypothetical clinical case that requires the reader to apply basic concepts learned from the systematic review and meta-analysis.

scholarly journals Personality disorder and alcohol treatment outcome: systematic review and meta-analysis

2017 ◽  
Vol 211 (1) ◽  
pp. 22-30 ◽  
Author(s):  
Giles M. Newton-Howes ◽  
James A. Foulds ◽  
Nicola H. Guy ◽  
Joseph M. Boden ◽  
Roger T. Mulder
Keyword(s):  
Systematic Review ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Treatment Outcomes ◽  
Meta Analysis ◽  
Current Evidence ◽  
Similar Amount ◽  
Quality Reporting ◽  
Conflicting Evidence ◽  
Retention In Treatment

BackgroundPersonality disorders commonly coexist with alcohol use disorders (AUDs), but there is conflicting evidence on their association with treatment outcomes.AimsTo determine the size and direction of the association between personality disorder and the outcome of treatment for AUD.MethodWe conducted a systematic review and meta-analysis of randomised trials and longitudinal studies.ResultsPersonality disorders were associated with more alcohol-related impairment at baseline and less retention in treatment. However, during follow-up people with a personality disorder showed a similar amount of improvement in alcohol outcomes to that of people without such disorder. Synthesis of evidence was hampered by variable outcome reporting and a low quality of evidence overall.ConclusionsCurrent evidence suggests the pessimism about treatment outcomes for this group of patients may be unfounded. However, there is an urgent need for more consistent and better quality reporting of outcomes in future studies in this area.

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