scholarly journals One-year symptom trajectories in patients with stable schizophrenia maintained on antipsychotics versus placebo: meta-analysis

2017 ◽  
Vol 211 (3) ◽  
pp. 137-143 ◽  
Author(s):  
Hiroyoshi Takeuchi ◽  
Navot Kantor ◽  
Marcos Sanches ◽  
Gagan Fervaha ◽  
Ofer Agid ◽  
...  
Keyword(s):  
Rating Scales ◽  
Mixed Model ◽  
Rating Scale ◽  
Meta Analysis ◽  
Placebo Treatment ◽  
Antipsychotic Treatment ◽  
Regression Analyses ◽  
Symptom Trajectories ◽  
Meta Regression ◽  
Randomised Controlled

BackgroundAs definitions of relapse differ substantially between studies, in investigations involving data aggregation, total scores on clinical rating scales provide a more generalisable outcome.AimsTo compare total symptom trajectories for antipsychotic versus placebo treatment over a 1-year period of maintenance treatment in schizophrenia.MethodRandomised controlled trials with antipsychotic and placebo treatment arms in patients with stable schizophrenia that reported Positive and Negative Syndrome Scale and Brief Psychiatric Rating Scale total scores at more than one time point were included. Meta-regression analyses were employed using a mixed model.ResultsA total of 11 studies involving 2826 patients were included. Meta-regression analyses revealed significant interactions between group and time (PS<0.0001); both standardised total scores and per cent score changes remained almost unchanged in patients continuing antipsychotic treatment, whereas symptoms continuously worsened over time in those switching to placebo treatment.ConclusionsWhen considering long-term antipsychotic treatment of schizophrenia, clinicians must balance symptomatic and functional outcomes.

scholarly journals Comparison of psychotherapies for adult depression to pill placebo control groups: a meta-analysis

2013 ◽  
Vol 44 (4) ◽  
pp. 685-695 ◽  
Author(s):  
P. Cuijpers ◽  
E. H. Turner ◽  
D. C. Mohr ◽  
S. G. Hofmann ◽  
G. Andersson ◽  
...  
Keyword(s):  
Effect Size ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Meta Analysis ◽  
Placebo Control ◽  
Number Needed To Treat ◽  
Regression Analyses ◽  
Post Test ◽  
Meta Regression

BackgroundThe effects of antidepressants for treating depressive disorders have been overestimated because of selective publication of positive trials. Reanalyses that include unpublished trials have yielded reduced effect sizes. This in turn has led to claims that antidepressants have clinically insignificant advantages over placebo and that psychotherapy is therefore a better alternative. To test this, we conducted a meta-analysis of studies comparing psychotherapy with pill placebo.MethodTen 10 studies comparing psychotherapies with pill placebo were identified. In total, 1240 patients were included in these studies. For each study, Hedges’ g was calculated. Characteristics of the studies were extracted for subgroup and meta-regression analyses.ResultsThe effect of psychotherapy compared to pill placebo at post-test was g = 0.25 [95% confidence interval (CI) 0.14–0.36, I2 = 0%, 95% CI 0–58]. This effect size corresponds to a number needed to treat (NNT) of 7.14 (95% CI 5.00–12.82). The psychotherapy conditions scored 2.66 points lower on the Hamilton Depression Rating Scale (HAMD) than the placebo conditions, and 3.20 points lower on the Beck Depression Inventory (BDI). Some indications for publication bias were found (two missing studies). We found no significant differences between subgroups of the studies and in meta-regression analyses we found no significant association between baseline severity and effect size.ConclusionsAlthough there are differences between the role of placebo in psychotherapy and pharmacotherapy research, psychotherapy has an effect size that is comparable to that of antidepressant medications. Whether these effects should be deemed clinically relevant remains open to debate.

scholarly journals Efficacy of onabotulinumtoxinA in the treatment of unipolar major depression: Systematic review, meta-analysis and meta-regression analyses of double-blind randomised controlled trials

2021 ◽  
pp. 026988112199182
Author(s):  
Danilo Arnone ◽  
Hassan Galadari ◽  
Carl J Rodgers ◽  
Linda Östlundh ◽  
Karim Abdel Aziz ◽  
...  
Keyword(s):  
Major Depression ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Regression Analyses ◽  
Double Blind ◽  
Pharmacological Interactions ◽  
Meta Regression ◽  
Randomised Controlled ◽  
Meta Analyses

Background: OnabotulinumtoxinA is a novel therapeutic intervention whose mechanism of action is believed to modify the negative facial feedback, thus abating symptoms of depression. This putative new antidepressant agent offers minimal systemic side effects and negligible risk of pharmacological interactions. We set out to examine the evidence for the use of onabotulinumtoxinA in major depression. Methods: A systematic search of the literature identified double-blind randomised controlled trials (RCTs) investigating the use of onabotulinumtoxinA in the treatment of major depression versus placebo. Data, reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA), was combined in meta-analyses (PROSPERO registration ID: CRD42020183538). Results: The search identified five RCTs (four double-blind) comparing onabotulinumtoxinA to placebo. OnabotulinumtoxinA was more effective than placebo when administered within the 20–40 IU dose range in double-blind RCTs. The analysis was free of publication bias and significantly heterogeneous. Meta-regression analyses indicated that onabotulinumtoxinA was more efficacious in women and in higher doses in female patients and less effective with polypharmacy, especially when an increasing number of antidepressants were prescribed. The effectiveness of onabotulinumtoxinA was higher in more recently published double-blind RCTs. Conclusion: The meta-analysis supports the efficacy of the intervention with the results being highly heterogeneous across studies. In view of the heterogeneity of the findings and the significant moderators of benefit (sex, year of study completion and the interaction between sex and dose), more research is required to better understand the role of onabotulinumtoxinA in the treatment of depression.

scholarly journals Effect of soya protein on blood pressure: a meta-analysis of randomised controlled trials

2011 ◽  
Vol 106 (3) ◽  
pp. 317-326 ◽  
Author(s):  
Jia-Yi Dong ◽  
Xing Tong ◽  
Zhi-Wei Wu ◽  
Peng-Cheng Xun ◽  
Ka He ◽  
...  
Keyword(s):  
Protein Intake ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Control Diet ◽  
Soya Protein ◽  
Controlled Trials ◽  
Regression Analyses ◽  
Meta Regression ◽  
Pre Treatment ◽  
Randomised Controlled

Observational studies have indicated that soya food consumption is inversely associated with blood pressure (BP). Evidence from randomised controlled trials (RCT) on the BP-lowering effects of soya protein intake is inconclusive. We aimed to evaluate the effectiveness of soya protein intake in lowering BP. The PubMed database was searched for published RCT in the English language through to April 2010, which compared a soya protein diet with a control diet. We conducted a random-effects meta-analysis to examine the effects of soya protein on BP. Subgroup and meta-regression analyses were performed to explore possible explanations for heterogeneity among trials. Meta-analyses of twenty-seven RCT showed a mean decrease of 2·21 mmHg (95 % CI − 4·10, − 0·33; P = 0·021) for systolic BP (SBP) and 1·44 mmHg (95 % CI − 2·56, − 0·31; P = 0·012) for diastolic BP (DBP), comparing the participants in the soya protein group with those in the control group. Soya protein consumption significantly reduced SBP and DBP in both hypertensive and normotensive subjects, and the reductions were markedly greater in hypertensive subjects. Significant and greater BP reductions were also observed in trials using carbohydrate, but not milk products, as the control diet. Meta-regression analyses further revealed a significantly inverse association between pre-treatment BP and the level of BP reductions. In conclusion, soya protein intake, compared with a control diet, significantly reduces both SBP and DBP, but the BP reductions are related to pre-treatment BP levels of subjects and the type of control diet used as comparison.

scholarly journals The Prognostic Significance of Combined Pretreatment Fibrinogen and Neutrophil-Lymphocyte Ratio in Various Cancers: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Rongqiang Liu ◽  
Shiyang Zheng ◽  
Qing Yuan ◽  
Peiwen Zhu ◽  
Biao Li ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Progression Free Survival ◽  
Regression Analyses ◽  
Free Survival ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Meta Regression

Purpose. The prognostic value of a new scoring system, termed F-NLR, that combines pretreatment fibrinogen level with neutrophil-lymphocyte ratio has been evaluated in various cancers. However, the results are controversial. The purpose of this study was to comprehensively analyze the prognostic value of F-NLR score in patients with cancers. Methods. An integrated search of relevant studies was conducted by screening the PubMed and Embase databases. Pooled hazard ratios, with 95% confidence intervals (CIs), for overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS) were calculated to estimate the prognostic significance of F-NLR score in patients with various tumors. A random effects model was used for comprehensive analysis, and subgroup and meta-regression analyses were used to explore sources of heterogeneity. Results. Thirteen articles reporting data from of 4747 patients were included in the study. Pooled analysis revealed that high F-NLR score was significantly associated with poor OS ( HR = 1.77 ; 95% CI, 1.51–2.08) and poor DFS/PFS ( HR = 1.63 ; 95% CI, 1.30–2.05). Subgroup and meta-regression analyses did not alter the prognostic role of F-NLR score in OS and DFS/PFS. Conclusions. Increased F-NLR score is significantly associated with poor prognosis in patients with cancers and can serve as an effective prognostic indicator.

scholarly journals Effects of statins in patients with chronic kidney disease: meta-analysis and meta-regression of randomised controlled trials

BMJ ◽  
2008 ◽  
Vol 336 (7645) ◽  
pp. 645-651 ◽  
Author(s):  
Giovanni F M Strippoli ◽  
Sankar D Navaneethan ◽  
David W Johnson ◽  
Vlado Perkovic ◽  
Fabio Pellegrini ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Meta Regression ◽  
Randomised Controlled

Emotional Intelligence and Attachment in Adulthood: A Meta-analysis

2021 ◽  
Author(s):  
Sarah A Walker ◽  
Kit S Double ◽  
Hannah Kunst ◽  
Michael Zhang ◽  
Carolyn MacCann
Keyword(s):  
Emotional Intelligence ◽  
Attachment Styles ◽  
Rating Scales ◽  
Meta Analysis ◽  
Secure Attachment ◽  
Emotional Experiences ◽  
Anxious Attachment ◽  
Avoidant Attachment ◽  
Causal Direction ◽  
Meta Regression

Attachment styles form during childhood emotional experiences. These experiences may be shaped by emotion-related traits such as how children interpret and regulate their own and others' emotions. These emotion-related traits appear in many emotional intelligence (EI) models, such that EI may relate to attachment styles. We conduct a meta-analysis to estimate the association between EI and attachment styles (26 studies, N = 6914). We include only non-clinical adult samples and validated psychometric assessments. We examine EI type as a moderator, comparing ability EI versus EI rating-scales using subgroups analysis and meta-regression. We find that lower anxious attachment is significantly associated with EI rating-scales (r = −0.25, k = 26) and ability EI (r = −0.16, k = 45), lower avoidant attachment is significantly associated with EI rating-scales (r = −0.36, k = 21) and ability EI (r = −0.21, k = 40), but secure attachment is significantly associated with EI rating-scales only (r = 0.31, k = 30). EI type significantly moderated the EI/avoidant attachment association only (β = −0.14, p = .01). We discuss possible mechanisms by which EI could influence early development of attachment styles (and vice-versa) while acknowledging that the causal direction underlying EI/attachment associations is unclear.

scholarly journals Time course of improvement with antipsychotic medication in treatment-resistant schizophrenia

2011 ◽  
Vol 199 (4) ◽  
pp. 275-280 ◽  
Author(s):  
Takefumi Suzuki ◽  
Gary Remington ◽  
Tamara Arenovich ◽  
Hiroyuki Uchida ◽  
Ofer Agid ◽  
...  
Keyword(s):  
Antipsychotic Medication ◽  
Time Course ◽  
Rating Scale ◽  
Antipsychotic Treatment ◽  
Treatment Resistant ◽  
Item Score ◽  
Double Blind ◽  
The Mean ◽  
Meta Regression ◽  
Item Scores

BackgroundImprovements are greatest in the earlier weeks of antipsychotic treatment of patients with non-resistant schizophrenia.AimsTo address the early time-line for improvement with antipsychotics in treatment-resistant schizophrenia.MethodRandomised double-blind trials of antipsychotic medication in adult patients with treatment-resistant schizophrenia were investigated (last search June 2010). A series of meta-regression analyses were carried out to examine the effect of time on the average item scores in the Positive and Negative Syndrome Scale (PANSS) or Brief Psychiatric Rating Scale (BPRS) at three or more distinct time points within the first 6 weeks of treatment.ResultsStudy duration varied from 4 weeks to 1 year and the definitions of treatment resistance as well as of treatment response were not necessarily consistent across 19 identified studies, resulting in highly variable rates of response (0–76%). The mean standardised baseline item score in the PANSS or BPRS was 3.4 (s.e. = 0.06) in the five studies included in the meta-regression analysis, with the average baseline Clinical Global Impression – Severity score being 5.2 (marked illness). For the pooled population treated with a range of antipsychotics (n = 1019), significant reductions in the mean item scores occurred during the first 4 weeks; improvements observed in later weeks were smaller and non-significant. In contrast, weekly improvement with clozapine was significant throughout (n = 356).ConclusionsOur findings provide preliminary evidence that the majority of improvement with antipsychotics may occur relatively early. More consistent improvements with clozapine may be associated with a gradual titration. To further elucidate response patterns, future studies are needed to provide data over regular intervals during earlier stages of treatment.

scholarly journals Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis

BMJ ◽  
2020 ◽  
pp. m1361 ◽  
Author(s):  
Elpida Vounzoulaki ◽  
Kamlesh Khunti ◽  
Sophia C Abner ◽  
Bee K Tan ◽  
Melanie J Davies ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Meta Analysis ◽  
Healthy Controls ◽  
Regression Analyses ◽  
White Population ◽  
History Of ◽  
Meta Regression

AbstractObjectiveTo estimate and compare progression rates to type 2 diabetes mellitus (T2DM) in women with gestational diabetes mellitus (GDM) and healthy controls.DesignSystematic review and meta-analysis.Data sourcesMedline and Embase between January 2000 and December 2019, studies published in English and conducted on humans.Eligibility criteria for selecting studiesObservational studies investigating progression to T2DM. Inclusion criteria were postpartum follow-up for at least 12 months, incident physician based diagnosis of diabetes, T2DM reported as a separate outcome rather than combined with impaired fasting glucose or impaired glucose tolerance, and studies with both a group of patients with GDM and a control group.ResultsThis meta-analysis of 20 studies assessed a total of 1 332 373 individuals (67 956 women with GDM and 1 264 417 controls). Data were pooled by random effects meta-analysis models, and heterogeneity was assessed by use of the I2 statistic. The pooled relative risk for the incidence of T2DM between participants with GDM and controls was estimated. Reasons for heterogeneity between studies were investigated by prespecified subgroup and meta-regression analyses. Publication bias was assessed by funnel plots and, overall, studies were deemed to have a low risk of bias (P=0.58 and P=0.90). The overall relative risk for T2DM was almost 10 times higher in women with previous GDM than in healthy controls (9.51, 95% confidence interval 7.14 to 12.67, P<0.001). In populations of women with previous GDM, the cumulative incidence of T2DM was 16.46% (95% confidence interval 16.16% to 16.77%) in women of mixed ethnicity, 15.58% (13.30% to 17.86%) in a predominantly non-white population, and 9.91% (9.39% to 10.42%) in a white population. These differences were not statistically significant between subgroups (white v mixed populations, P=0.26; white v non-white populations, P=0.54). Meta-regression analyses showed that the study effect size was not significantly associated with mean study age, body mass index, publication year, and length of follow-up.ConclusionsWomen with a history of GDM appear to have a nearly 10-fold higher risk of developing T2DM than those with a normoglycaemic pregnancy. The magnitude of this risk highlights the importance of intervening to prevent the onset of T2DM, particularly in the early years after pregnancy.Systematic review registrationPROSPERO CRD42019123079.

scholarly journals The Validity of Teacher Rating Scales for the Assessment of ADHD Symptoms in the Classroom: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 108705472091683
Author(s):  
Anouck I. Staff ◽  
Jaap Oosterlaan ◽  
Saskia van der Oord ◽  
Pieter J. Hoekstra ◽  
Karen Vertessen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Convergent Validity ◽  
Rating Scales ◽  
Rating Scale ◽  
Meta Analysis ◽  
Teacher Rating ◽  
Impulsive Behavior ◽  
Adhd Symptoms ◽  
Clinical Interviews ◽  
Scale Scores

Objective: To assess attention-deficit/hyperactivity disorder (ADHD) symptoms in the classroom, most often teacher rating scales are used. However, clinical interviews and observations are recommended as gold standard assessment. This systematic review and meta-analysis evaluates the validity of teacher rating scales. Method: Twenty-two studies ( N = 3,947 children) assessing ADHD symptoms using teacher rating scale and either semi-structured clinical interview or structured classroom observation were meta-analyzed. Results: Results showed convergent validity for rating scale scores, with the strongest correlations ( r = .55–.64) for validation against interviews, and for hyperactive–impulsive behavior. Divergent validity was confirmed for teacher ratings validated against interviews, whereas validated against observations this was confirmed for inattention only. Conclusion: Teacher rating scales appear a valid and time-efficient measure to assess classroom ADHD; although validated against semi-structured clinical interviews, there were only a few studies available. Low correlations between ratings and structured observations of inattention suggest that observations could add information above rating scales.

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