scholarly journals The Effect of Adjunctive Mangosteen Pericarp on Cognition in People With Schizophrenia: Secondary Analysis of a Randomized Controlled Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Wolfgang Marx ◽  
David R. Skvarc ◽  
Mohammadreza Mohebbi ◽  
Adam J. Walker ◽  
Alcy Meehan ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Visual Learning ◽  
Secondary Analysis ◽  
Cognitive Outcomes ◽  
Garcinia Mangostana ◽  
Cognitive Domains ◽  
Optimal Dosing ◽  
Dosing Strategies ◽  
The Relationship

Background: Cognitive impairment is prevalent and often highly burdensome in people with schizophrenia. The aim of this study was to investigate if mangosteen (Garcinia mangostana Linn.) pericarp extract may be an effective intervention to improve cognitive performance in this population.Methods: This was a secondary analysis of a larger randomized placebo-controlled trial that investigated a 24-weeks intervention of mangosteen pericarp extract supplementation in people diagnosed with schizophrenia. A subset of n = 114 participants with completed cognitive outcomes at follow up were included in this analysis. Using the Cogstate Brief Battery, the following cognitive outcomes were assessed: psychomotor function, attention, visual learning and memory (visual and working). Subgroup analyses investigated whether baseline clinical parameters (baseline cognitive functioning, illness severity and duration, depressive symptoms) moderated the relationship between mangosteen pericarp extract intervention and change in cognitive outcomes.Results: There were no significant between-group changes in any cognitive outcomes assessed. Subgroup analysis based on baseline cognition and clinical characteristics did not reveal any significant between-group difference in change.Conclusions: Mangosteen pericarp extract did not affect cognitive outcomes in people with schizophrenia. Further investigation regarding optimal dosing strategies for mangosteen interventions and the testing of additional cognitive domains may be warranted.Trial Registration:ANZCTR.org.au identifier: ACTRN12616000859482, registered 30 June 3 2016.

scholarly journals Personality Pathology Predicts Outcomes in a Treatment-Seeking Sample with Bipolar I Disorder

2014 ◽  
Vol 2014 ◽  
pp. 1-9
Author(s):  
Susan J. Wenze ◽  
Brandon A. Gaudiano ◽  
Lauren M. Weinstock ◽  
Ivan W. Miller
Keyword(s):  
Psychosocial Functioning ◽  
Secondary Analysis ◽  
Personality Pathology ◽  
Treatment Seeking ◽  
Categorical Approach ◽  
Bipolar I Disorder ◽  
Manic Symptoms ◽  
Percent Time ◽  
The Relationship

We conducted a secondary analysis of data from a clinical trial to explore the relationship between degree of personality disorder (PD) pathology (i.e., number of subthreshold and threshold PD symptoms) and mood and functioning outcomes in Bipolar I Disorder (BD-I). Ninety-two participants completed baseline mood and functioning assessments and then underwent 4 months of treatment for an index manic, mixed, or depressed phase acute episode. Additional assessments occurred over a 28-month follow-up period. PD pathology did not predict psychosocial functioning or manic symptoms at 4 or 28 months. However, it did predict depressive symptoms at both timepoints, as well as percent time symptomatic. Clusters A and C pathology were most strongly associated with depression. Our findings fit with the literature highlighting the negative repercussions of PD pathology on a range of outcomes in mood disorders. This study builds upon previous research, which has largely focused on major depression and which has primarily taken a categorical approach to examining PD pathology in BD.

The relationship between exclusion from school and mental health: a secondary analysis of the British Child and Adolescent Mental Health Surveys 2004 and 2007

2017 ◽  
Vol 48 (4) ◽  
pp. 629-641 ◽  
Author(s):  
T. Ford ◽  
C. Parker ◽  
J. Salim ◽  
R. Goodman ◽  
S. Logan ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Psychiatric Disorder ◽  
Health Surveys ◽  
Secondary Analysis ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
The Impact ◽  
The Relationship

BackgroundChildren with poor mental health often struggle at school. The relationship between childhood psychiatric disorder and exclusion from school has not been frequently studied, but both are associated with poor adult outcomes. We undertook a secondary analysis of the British Child and Adolescent Mental Health Surveys from 2004 and its follow-up in 2007 to explore the relationship between exclusion from school and psychopathology. We predicted poorer mental health among those excluded.MethodPsychopathology was measured using the Strengths and Difficulties Questionnaire, while psychiatric disorder was assessed using the Development and Well-Being Assessment and applying Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM IV) criteria. Exclusion from school and socio-demographic characteristics were reported by parents. Multi-variable regression models were used to examine the impact of individual factors on exclusion from school or psychological distress.ResultsExclusion from school was commoner among boys, secondary school pupils and those living in socio-economically deprived circumstances. Poor general health and learning disability among children and poor parental mental health were also associated with exclusion. There were consistently high levels of psychological distress among those who had experienced exclusion at baseline and follow-up.ConclusionsWe detected a bi-directional association between psychological distress and exclusion. Efforts to identify and support children who struggle with school may therefore prevent both future exclusion and future psychiatric disorder.

scholarly journals Effect of vitamin B6 supplementation, in combination with magnesium, on severe stress and magnesium status: secondary analysis from an RCT

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Lionel Noah ◽  
Gisèle Pickering ◽  
Claude Dubray ◽  
Andre Mazur ◽  
Simon Hitier ◽  
...  
Keyword(s):  
General Population ◽  
Vitamin B6 ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Subscale Score ◽  
Normal Range ◽  
Parallel Group ◽  
Stress Score ◽  
Randomised Controlled ◽  
The Relationship

AbstractIntroductionEvidence from a recent randomised controlled trial1 suggests that in severely stressed subjects with low magnesemia, supplementation with magnesium (Mg) in combination with vitamin B6 (B6) provides greater benefits than Mg alone. B6 was reported to facilitate Mg absorption and its cellular uptake and to exert synergistic effect with Mg. The current secondary analysis explored the relationship between Mg-B6 combination and erythrocyte Mg concentration, used as a biomarker of body Mg status.Material and MethodsAn 8-week, Phase IV, controlled, single-blinded, parallel-group trial (EudraCT Number 2015-003749-24) stratified by sex was conducted in adults (n = 264) with a Depression Anxiety Stress Scales - stress subscale score (DASS-42SS) > 18 and serum Mg of 0.5–0.85mmol/L, randomised 1:1 to daily oral Mg-B6 (Magne B6®, Mg 300 mg; B6 30mg) or oral Mg alone (Magnespasmyl®, Mg 300mg). Outcomes were stress score, serum Mg (mmol/L), erythrocytes Mg (mmol/L), and serum B6 (nmol/L) from baseline to Week4 and Week8. Data are given as mean(SD) values.Results & DiscussionBaseline characteristics. Baseline magnesemia was 0.80(0.04) for both groups. Erythrocyte Mg concentration for the lower quintile of the studied population (n = 53) was 0.73–1.62, below the normal range of 1.65–2.65 in general population. The mean stress score in this subgroup was higher [29.5(6.3)], but not significantly different from that in other quintiles [lowest value: 26.1(7.6)]. Baseline B6 serum level for the lower B6 quintile (5–23), below the normal range for general population, was suggestive of possible B6 deficiency.Treatment effects. Both treatments increased slightly but not significantly erythrocyte Mg level from baseline to Week8 [1.84(0.03) to 1.86(0.03), and 1.86(0.03) to 188(0.03), respectively for Mg + B6 and Mg groups]. Significant changes were observed in subjects with low erythrocyte Mg level at baseline (< 1.6), namely an increase of + 0.13(0.04–0.22) for Mg + B6 and + 0.17(0.08–0.25) for Mg groups, but with no difference between treatments. Moreover, Mg + B6 supplementation led to a significant change (p < 0.0001) in serum B6 level between baseline and Wk8 [55.9(4.8) to 370.9(11.3)], as compared to Mg alone [51.9(4.8) to 51.5(11.3)].In conclusion, both treatments significantly increased erythrocyte Mg in subjects with low Mg status. B6 supplementation did not lead to further increase in erythrocyte Mg level. We have previously shown that severely stressed population benefits from B6 supplementation in combination with Mg, however, the mechanism of the interaction between Mg and B6 remains to be elucidated.1Sponsored by Sanofi

scholarly journals The relationship between pain, analgesics and survival in patients with advanced cancer; a secondary data analysis of the international European palliative care Cancer symptom study.

2019 ◽  
Vol 76 (3) ◽  
pp. 393-402 ◽  
Author(s):  
Jason W Boland ◽  
Victoria Allgar ◽  
Elaine G Boland ◽  
Mike I Bennett ◽  
Stein Kaasa ◽  
...  
Keyword(s):  
Palliative Care ◽  
Subgroup Analysis ◽  
Clinical Decision Making ◽  
Secondary Analysis ◽  
Opioid Use ◽  
Sensitivity Testing ◽  
Pain Analgesics ◽  
Prospective Longitudinal ◽  
The Relationship

Abstract Purpose Opioids reduce cancer-related pain but an association with shorter survival is variably reported. Aim: To investigate the relationship between pain, analgesics, cancer and survival within the European Palliative Care Cancer Symptom (EPCCS) study to help inform clinical decision making. Methods Secondary analysis of the international prospective, longitudinal EPCCS study which included 1739 adults with advanced, incurable cancer receiving palliative care. In this secondary analysis, for all participants with date of death or last follow up, a multilevel Weibull survival analysis examined whether pain, analgesics, and other relevant variables are associated with time to death. Results Date of death or last follow-up was available for 1404 patients (mean age 65.7 [SD:12.3];men 50%). Secondary analysis of this group showed the mean survival from baseline was 46.5 (SD:1.5) weeks (95% CI:43.6–49.3). Pain was reported by 76%; 60% were taking opioids, 51% non-opioid analgesics and 24% co-analgesics. Opioid-use was associated with decreased survival in the multivariable model (HR = 1.59 (95% CI:1.38–1.84), p < 0.001). An exploratory subgroup analysis of those with C-reactive protein (CRP) measures (n = 219) indicated higher CRP was associated with poorer survival (p = 0.001). In this model, the strength of relationship between survival and opioid-use weakened (p = 0.029). Conclusion Opioid-use and survival were associated; this relationship weakened in a small sensitivity-testing subgroup analysis adjusting for CRP. Thus, the observed relationship between survival and opioid-use may partly be due to tumour-related inflammation. Larger studies, measuring disease activity, are needed to confirm this finding to more accurately judge the benefits and risks of opioids in advanced progressive disease.

scholarly journals Sleep Disturbance and the Risk of Cognitive Decline or Clinical Conversion in the ADNI Cohort

2018 ◽  
Vol 45 (3-4) ◽  
pp. 232-242 ◽  
Author(s):  
Adam P. Mecca ◽  
Hannah R. Michalak ◽  
Julia W. McDonald ◽  
Emily C. Kemp ◽  
Erika A. Pugh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Sleep Disturbance ◽  
Secondary Analysis ◽  
Study Results ◽  
Global Cognition ◽  
The Relationship ◽  
Normal Cognition

Background: We investigated the relationship between sleep disturbance and cognitive decline or clinical conversion in individuals with normal cognition (CN), as well as those with mild cognitive impairment (MCI) and dementia due to Alzheimer disease (AD-dementia). Methods: Secondary analysis of 1,629 adults between 48 and 91 years of age with up to 24 months of follow-up from the ADNI (Alzheimer’s Disease Neuroimaging Initiative), a longitudinal cohort study. Results: Sleep disturbance was not associated with decline in memory, executive function, or global cognition. The presence of sleep disturbance did not significantly increase the risk of diagnostic conversion in CN, early MCI, or late MCI participants. Conclusion: This study investigated the effect of sleep disturbance on cognitive decline using several outcomes and does not support the hypothesis that sleep disturbance predicts subsequent cognitive decline.

scholarly journals A randomised controlled trial of adjunctive yoga and adjunctive physical exercise training for cognitive dysfunction in schizophrenia

2016 ◽  
Vol 29 (2) ◽  
pp. 102-114 ◽  
Author(s):  
Triptish Bhatia ◽  
Sati Mazumdar ◽  
Joel Wood ◽  
Fanyin He ◽  
Raquel E. Gur ◽  
...  
Keyword(s):  
Pilot Study ◽  
Randomised Controlled Trial ◽  
Exercise Training ◽  
Physical Exercise ◽  
Cognitive Functions ◽  
Controlled Trial ◽  
Cognitive Domains ◽  
Physical Exercise Training ◽  
Randomised Controlled

BackgroundYoga and physical exercise have been used as adjunctive intervention for cognitive dysfunction in schizophrenia (SZ), but controlled comparisons are lacking.AimsA single-blind randomised controlled trial was designed to evaluate whether yoga training or physical exercise training enhance cognitive functions in SZ, based on a prior pilot study.MethodsConsenting, clinically stable, adult outpatients with SZ (n=286) completed baseline assessments and were randomised to treatment as usual (TAU), supervised yoga training with TAU (YT) or supervised physical exercise training with TAU (PE). Based on the pilot study, the primary outcome measure was speed index for the cognitive domain of ‘attention’ in the Penn computerised neurocognitive battery. Using mixed models and contrasts, cognitive functions at baseline, 21 days (end of training), 3 and 6 months post-training were evaluated with intention-to-treat paradigm.ResultsSpeed index of attention domain in the YT group showed greater improvement than PE at 6 months follow-up (p<0.036, effect size 0.51). In the PE group, ‘accuracy index of attention domain showed greater improvement than TAU alone at 6-month follow-up (p<0.025, effect size 0.61). For several other cognitive domains, significant improvements were observed with YT or PE compared with TAU alone (p<0.05, effect sizes 0.30–1.97).ConclusionsBoth YT and PE improved attention and additional cognitive domains well past the training period, supporting our prior reported beneficial effect of YT on speed index of attention domain. As adjuncts, YT or PE can benefit individuals with SZ.

scholarly journals The association between usage and outcomes of an online intervention for depression: how optimal dosage can help establish adherence (Preprint)

2018 ◽  
Author(s):  
Angel Enrique Roig ◽  
Jorge Palacios ◽  
Holly Ryan ◽  
Derek Richards
Keyword(s):  
Behavioral Therapy ◽  
Controlled Trial ◽  
Community Sample ◽  
Secondary Analysis ◽  
Optimal Dose ◽  
Program Completion ◽  
Optimal Dosage ◽  
Internet Interventions ◽  
The Relationship ◽  
Usage Metrics

BACKGROUND Internet interventions are able to easily generate objective data about program usage. Increasingly, more studies are exploring the relationship between usage and outcomes but they often report different metrics of use and the findings are mixed. Thus, current evaluations fail to demonstrate which metrics should be considered and if it is possible to determine an optimal dose-response relationship which can inform thresholds for adherence and clinically meaningful change. OBJECTIVE This study aimed to explore the relationship between several usage metrics and outcomes; and determine an optimal dose of usage of an internet intervention for depression. METHODS This is a secondary analysis of data from a Randomized Controlled Trial that examined the efficacy of an internet-based Cognitive-Behavioral Therapy (iCBT) program for depression (Space from Depression) in an adult community sample. Space from Depression is a seven-module, supported intervention delivered over a period of 8 weeks. Supporters were trained volunteers who provided feedback to participants on a weekly basis. Different usage metrics (i.e. time spent, modules and activities completed, percentage of program completion) were automatically collected by the platform and composite variables from these (e.g. activities per session) were computed. A breakdown of the usage metrics was obtained by weeks. For the analysis, the sample was divided into those who obtained a reliable change (RC) (Beck Depression Inventory [BDI-II] change >8) and those who did not. RESULTS Data from 216 users who used the intervention and completed pre and post-treatment outcomes were included in the analyses. 89 participants obtained a RC and 127 did not. Those in the RC group significantly spent more time, had more logins, used more tools, viewed a higher percentage of the program and got more reviews from the supporter compared to those who did not obtain a RC. Differences between groups in usage was observed from first week in advance across the different metrics although they vanished over time. In the RC group, the usage was higher during the first four weeks and then a significant decrease was observed. ROC Curve analyses showed that the optimal cut-points for different usage metrics were 7 hours total time spent, 15 sessions, 30 tools used and 50% of program completion. CONCLUSIONS Overall, the results showed that those individuals who obtained RC after the intervention had higher levels of exposure to the platform. The usage during the first half of the intervention was higher and differences between groups were observed from the first week. This study also suggests that it is possible to determine an optimal dose and this can be used to inform the minimal usage to establish adherence. These results will help to better understand how to use internet interventions and what optimal level of engagement can most affect outcomes. CLINICALTRIAL The trial is registered as a controlled trial with ISRCTN (ISRCTN03704676).

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