scholarly journals Anticipatory Pleasure for Future Experiences in Schizophrenia-Spectrum Disorders and Major Depression: A Systematic Review and Meta-Analysis

2019 ◽  
Author(s):  
David John Hallford ◽  
Manoj Kumar Sharma
Keyword(s):  
Major Depression ◽  
Meta Analysis ◽  
Systemic Review ◽  
Schizophrenia Spectrum Disorders ◽  
Duration Of Illness ◽  
Schizophrenia Spectrum ◽  
Healthy Control ◽  
History Of ◽  
Spectrum Disorders ◽  
Academic Search

Objectives: Deficits in anticipating pleasure may be an important dimension of anhedonia and functioning in psychiatric disorders, particularly schizophrenia and depression, however, inconsistent findings have limited the conclusions that can be drawn. We conducted the first systemic review and meta-analysis of the extant literature for research comparing psychiatric groups to healthy control groups on anticipatory pleasure. Methods: Academic Search Complete, Science Direct and CINAHL databases were systematically searched up to June 9th 2018 for relevant peer-reviewed articles, book chapters, and dissertations. Reference lists were also hand searched. A total of 36 studies were included in the review.Results: A moderate-sized deficit was observed in schizophrenia-spectrum disorders (k = 32, 1851 patients and 1449 controls, g = -0.42 [95%CI = -0.53-0.31], p < .001), and a large deficit in major depression (k = 415 patients and 506 controls, g = -0.87 [95%CI = -1.23-0.51], p < .001), with this effect being significantly larger for depression (p < .05). Meta-regression showed that heterogeneity was partially explained in schizophrenia-spectrum by longer duration of illness and lower cognitive functioning predicting larger deficits. In depression, some evidence was found that ruling out a history of psychiatric illness in controls may be related to larger effects. There was evidence for small study bias inflating estimates in schizophrenia-spectrum disorders. Conclusions: Deficits in anticipatory pleasure are manifest in these disorders, and significantly more so in major depression. These findings indicate a possible therapeutic target to link cognitive

scholarly journals Demographic and clinical variables associated with response to clozapine in schizophrenia: a systematic review and meta-analysis

2021 ◽  
Vol 51 (3) ◽  
pp. 376-386
Author(s):  
Kira Griffiths ◽  
Edward Millgate ◽  
Alice Egerton ◽  
James H. MacCabe
Keyword(s):  
Meta Analysis ◽  
Schizophrenia Spectrum Disorders ◽  
Treatment Resistant ◽  
Illness Onset ◽  
Clozapine Treatment ◽  
Duration Of Illness ◽  
Schizophrenia Spectrum ◽  
Younger Age ◽  
Clozapine Response ◽  
Spectrum Disorders

AbstractClozapine is the only licensed pharmacotherapy for treatment-resistant schizophrenia. However, response to clozapine is variable. Understanding the demographic and clinical features associated with response to clozapine may be useful for patient stratification for clinical trials or for identifying patients for earlier initiation of clozapine. We systematically reviewed the literature to investigate clinical and demographic factors associated with variation in clozapine response in treatment-resistant patients with schizophrenia spectrum disorders. Subsequently, we performed a random-effects meta-analysis to evaluate differences in duration of illness, age at clozapine initiation, age of illness onset, body weight and years of education between clozapine responders and non-responders. Thirty-one articles were eligible for qualitative review and 17 of these were quantitatively reviewed. Shorter duration of illness, later illness onset, younger age at clozapine initiation, fewer hospitalisations and fewer antipsychotic trials prior to clozapine initiation showed a trend to be significantly associated with a better response to clozapine. Meta-analysis of seven studies, totalling 313 subjects, found that clozapine responders had a significantly shorter duration of illness compared to clozapine non-responders [g = 0.31; 95% confidence interval (CI) 0.06–0.56; p = 0.01]. The results imply that a delay in clozapine treatment may result in a poorer response and that a focus on prompt treatment with clozapine is warranted.

scholarly journals Cytokines in cerebrospinal fluid of patients with schizophrenia spectrum disorders: New data and an updated meta-analysis

2018 ◽  
Vol 202 ◽  
pp. 64-71 ◽  
Author(s):  
Juan A. Gallego ◽  
Emily A. Blanco ◽  
Sehba Husain-Krautter ◽  
E. Madeline Fagen ◽  
Paula Moreno-Merino ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Meta Analysis ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

scholarly journals Clinical correlates of the NR3C1 gene methylation at various stages of psychosis

2020 ◽  
Author(s):  
Błażej Misiak ◽  
Jerzy Samochowiec ◽  
Anna Konopka ◽  
Bożena Gawrońska-Szklarz ◽  
Jan Aleksander Beszłej ◽  
...  
Keyword(s):  
Clinical Population ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Childhood Experiences ◽  
Immediate Memory ◽  
Schizophrenia Spectrum ◽  
Adverse Childhood ◽  
General Functioning ◽  
History Of ◽  
Spectrum Disorders

Abstract Background Dysregulation of epigenetic processes might account for alterations of the hypothalamic-pituitary-adrenal axis observed in patients with schizophrenia. Therefore, in this study, we aimed to investigate methylation of the glucocorticoid receptor (NR3C1) gene in patients with schizophrenia-spectrum disorders, individuals at familial high risk of schizophrenia (FHR-P) and healthy controls (HCs) with respect to clinical manifestation and a history of psychosocial stressors. Methods We recruited 40 first-episode psychosis (FEP) patients, 45 acutely relapsed schizophrenia (SCZ-AR) patients, 39 FHR-P individuals and 56 HCs. The level of methylation at nine CpG sites of the NR3C1 gene was determined using pyrosequencing. Results The level of NR3C1 methylation was significantly lower in FEP patients and significantly higher in SCZ-AR patients compared to other subgroups of participants. Individuals with FHR-P and HCs had similar levels of NR3C1 methylation. A history of adverse childhood experiences (ACEs) was associated with significantly lower NR3C1 methylation in all subgroups of participants. Higher methylation of the NR3C1 gene was related to worse performance of attention and immediate memory as well as lower level of general functioning in patients with psychosis. Conclusions Patients with schizophrenia-spectrum disorders show altered levels of NR3C1 methylation that is significantly lower in FEP patients and significantly higher in SCZ-AR patients. Higher methylation of the NR3C1 gene might be related to cognitive impairment observed in this clinical population. The association between a history of ACEs and lower NR3C1 methylation is not specific to patients with psychosis. Longitudinal studies are needed to establish causal mechanisms underlying these observations.

scholarly journals A meta-analysis of client-therapist perspectives on the therapeutic alliance: Examining the moderating role of type of measurement and diagnosis

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Libby Igra ◽  
Michal Lavidor ◽  
Dana Atzil-Slonim ◽  
Nitzan Arnon-Ribenfeld ◽  
Steven de Jong ◽  
...  
Keyword(s):  
Therapeutic Alliance ◽  
Meta Analysis ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Mean Differences ◽  
Therapist Perspectives ◽  
Therapist Perspective ◽  
Moderating Role

Abstract Background: Clients and therapists often have different perspectives on their therapeutic alliance (TA), affecting the process and outcome of therapy. The aim of the present meta-analysis was to assess the mean differences between clients’ and therapists’ estimations of TA among clients with severe disturbances, while focusing on two potential moderators: client diagnosis and alliance instrument. Method: We conducted a systematic literature search of studies examining both client perspective and therapist perspective on TA in psychotherapy among people with schizophrenia spectrum disorders, personality disorders, and substance misuse disorders. We then analyzed the data using a random-effects meta-analytic model with Cohen’s d standardized mean effect size. Results: Heterogeneity analyses (k = 22, Cohen’s d = −.46, 95% confidence interval = .31–1.1) produced a significant Q-statistic (Q = 94.96) and indicated high heterogeneity, suggesting that moderator analyses were appropriate. Conclusions: Our findings show that the type of TA instrument moderates the agreement on TA between client and therapist, but there was no indication of the client’s diagnosis moderating the effect. The agreement between client and therapist estimations seems to be dependent on the instrument that is used to assess TA. Specific setting-related instruments seem to result in higher agreement between clients’ and therapists’ estimations than do more general instruments that are applied to assess TA.

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