Serotonin Transporter Genetic Variation and Antidepressant Response and Tolerability: A Systematic Review and Meta-Analysis

Antidepressants are used to treat several psychiatric disorders; however, a large proportion of patients do not respond to their first antidepressant therapy and often experience adverse drug reactions (ADR). A common insertion–deletion polymorphism in the promoter region (5-HTTLPR) of the serotonin transporter (SLC6A4) gene has been frequently investigated for its association with antidepressant outcomes. Here, we performed a systematic review and meta-analysis to assess 5-HTTLPR associations with antidepressants: (1) response in psychiatric disorders other than major depressive disorder (MDD) and (2) tolerability across all psychiatric disorders. Literature searches were performed up to January 2021, yielding 82 studies that met inclusion criteria, and 16 of these studies were included in the meta-analyses. Carriers of the 5-HTTLPR LL or LS genotypes were more likely to respond to antidepressant therapy, compared to the SS carriers in the total and European ancestry-only study populations. Long (L) allele carriers taking selective serotonin reuptake inhibitors (SSRIs) reported fewer ADRs relative to short/short (SS) carriers. European L carriers taking SSRIs had lower ADR rates than S carriers. These results suggest the 5-HTTLPR polymorphism may serve as a marker for antidepressant outcomes in psychiatric disorders and may be particularly relevant to SSRI treatment among individuals of European descent.

Download Full-text

Abstract WP196: Selective Serotonin Reuptake Inhibitors (SSRI) for Depression and Functional Recovery After Stroke: A Meta-Analysis

Stroke ◽

10.1161/str.51.suppl_1.wp196 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Thirumalaivasan Dhasakeerthi ◽

Muhammad Ishfaq ◽

Balaji Krishnaiah ◽

Andrei Alexandrov ◽

Georgios Tsivgoulis

Keyword(s):

Functional Recovery ◽

Selective Serotonin Reuptake Inhibitors ◽

Meta Analysis ◽

Potential Effect ◽

Control Group ◽

Random Effects Models ◽

Post Stroke Depression ◽

Meta Analyses ◽

And Function ◽

Ssri Treatment

Background: Post-stroke depression is common and it impedes rehabilitation and function recovery after stroke, and numerous trials evaluated SSRI’s for depression prophylaxis. The objective of this study is to assess the use of SSRI for prevention of poststroke depression and the potential effect on functional recovery after stroke. Methods: We searched electronic databases up to July 2019 for randomized controlled trials of SSRI’s for patients with stroke versus placebo. We calculated pooled odds ratios and 95% CIs by using random-effects models. The primary end points were depression and good functional outcome (modified Rankin Scale score of 0-2) at 90 days post-randomization. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Twelve randomized control trials assessing 4,887 patients have been included in the meta-analysis. SSRI treatment after stroke decreased the odds of depression compared to control group (OR = 0.48, 95% CI - 0.30 to 0.78, p=0.003). There was no heterogeneity between the trials (Cochran’s Q statistic 4.623, df 5; P = .337, I 2 =5.626%). The proportion of subjects who achieved mRS 0-2 at 90 days was similar between SSRI and control groups (OR= 3.471, 95% CI - 0.59 to 20.38, p=0.168). Conclusion: SSRI treatment for the stroke patients reduces the incidence of depression but it does not increase the odds of good functional recovery.

Download Full-text

Impact of Non-Confinement Accommodation on Farrowing Performance: A Systematic Review and Meta-Analysis of Farrowing Crates Versus Pens

Animals ◽

10.3390/ani9110957 ◽

2019 ◽

Vol 9 (11) ◽

pp. 957 ◽

Cited By ~ 1

Author(s):

Dannielle Glencorse ◽

Kate Plush ◽

Susan Hazel ◽

Darryl D’Souza ◽

Michelle Hebart

Keyword(s):

Systematic Review ◽

Relative Risk ◽

Web Of Science ◽

Meta Analysis ◽

Inclusion Criteria ◽

Literature Searches ◽

Piglet Mortality ◽

Partial Confinement ◽

Meta Analyses ◽

Piglet Survival

There are conflicting reports regarding the effect of farrowing house accommodation on piglet performance. The aim of this investigation was to use a systematic review and meta-analyses to summarise the results of publications that focused on direct comparisons between full confinement conventional crates and various designs of loose-housed farrowing pens from loading until weaning. Literature searches in Scopus, BIOSIS Previews, Cab Abstracts, and Web of Science identified 6695 articles. Twenty-two publications were retained for the systematic review and individual meta-analyses after screening for inclusion criteria. The random effects meta-analyses were performed on crate versus pen for number of piglets born alive, number of stillborn piglets, pre-weaning mortality, and number of piglets weaned. Additionally, the modifiers of confinement length (no confinement from loading until weaning or partial confinement for shorter periods of time in the early stages post parturition), enrichment (no enrichment or enrichment provided), and pen size (small, medium, or large) were examined. There was a 14% increase in the relative risk of piglet mortality in farrowing pens when they were compared with crates (p = 0.0015). The number of stillborns per litter was not different between the pen and crate. However, when providing enrichment in the pens, there was an increase in stillborns within farrowing crates versus pens (p = 0.009). There was no overall effect on piglets that were born alive or number weaned. As there is no difference between piglets born alive and mortality is significantly higher in farrowing pens, a reduction in the number of piglets weaned was expected but not observed, which was possibly due to the lack of weaning details provided in the publications. This was the first systematic review and meta-analysis conducted on the performance of farrowing accommodation and identified that farrowing pens do compromise post-natal piglet survival. Future efforts should focus on improving sow comfort in the farrowing crate to maximize both piglet and sow welfare.

Download Full-text

Psychiatric Manifestations of Coeliac Disease, a Systematic Review and Meta-Analysis

Nutrients ◽

10.3390/nu12010142 ◽

2020 ◽

Vol 12 (1) ◽

pp. 142 ◽

Cited By ~ 3

Author(s):

Emma Clappison ◽

Marios Hadjivassiliou ◽

Panagiotis Zis

Keyword(s):

Systematic Review ◽

Eating Disorders ◽

Coeliac Disease ◽

Psychiatric Disorders ◽

Meta Analysis ◽

Hyperactivity Disorder ◽

Increased Risk ◽

Meta Analyses ◽

Psychiatric Manifestations ◽

The Relationship

Background: Coeliac disease (CD) is increasingly prevalent and is associated with both gastrointestinal (GI) and extra-intestinal manifestations. Psychiatric disorders are amongst extra-intestinal manifestations proposed. The relationship between CD and such psychiatric disorders is not well recognised or understood. Aim: The aim of this systematic review and meta-analysis was to provide a greater understanding of the existing evidence and theories surrounding psychiatric manifestations of CD. Methodology: An online literature search using PubMed was conducted, the prevalence data for both CD and psychiatric disorders was extracted from eligible articles. Meta analyses on odds ratios were also performed. Results: A total of 37 articles were included in this review. A significant increase in risk was detected for autistic spectrum disorder (OR 1.53, 95% CI 1.24–1.88, p < 0.0001), attention deficit hyperactivity disorder (OR 1.39, 95% CI 1.18–1.63, p < 0.0001), depression (OR 2.17, 95% CI 2.17–11.15, p < 0.0001), anxiety (OR 6.03, 95% CI 2.22–16.35, p < 0.0001), and eating disorders (OR 1.62, 95% CI 1.37–1.91, p < 0.00001) amongst the CD population compared to healthy controls. No significant differences were found for bipolar disorder (OR 2.35, 95% CI 2.29–19.21, p = 0.43) or schizophrenia (OR 0.46, 95% CI 0.02–10.18, p = 0.62). Conclusion: CD is associated with an increased risk of depression, anxiety, eating disorders as well as ASD and ADHD. More research is required to investigate specific biological explanations as well as any effect of gluten free diet.

Download Full-text

Treatment of Postural Orthostatic Tachycardia Syndrome With Medication: A Systematic Review

Journal of Child Neurology ◽

10.1177/0883073820948679 ◽

2020 ◽

Vol 35 (14) ◽

pp. 1004-1016 ◽

Cited By ~ 1

Author(s):

Bashar Hasan ◽

Jehad Almasri ◽

Bilal Marwa ◽

Kelsey M. Klaas ◽

Philip R. Fischer

Keyword(s):

Systematic Review ◽

English Language ◽

Selective Serotonin Reuptake Inhibitors ◽

Beta Blockers ◽

Meta Analysis ◽

Quality Data ◽

Favorable Effect ◽

Control Group ◽

Postural Orthostatic Tachycardia Syndrome ◽

Meta Analyses

Purpose: Postural orthostatic tachycardia syndrome has been recognized for decades, but treatment is largely based on anecdotal experience and expert opinion. Pharmacologic treatment is inconsistent and unstandardized. We did a systematic review to identify controlled studies from which informed treatment decisions can be made. Method: Through a standard systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we identified all English-language studies of a medication treatment for postural orthostatic tachycardia syndrome that included a comparison or control group and followed outcomes for at least 1 week of treatment. Results: A total of 626 studies were identified by the search criteria, and 8, involving a total of 499 patients, met the criteria. No studies were adequately similar to allow for meta-analysis. Of the identified 8 studies, 2 were randomized controlled trials and 4 had been subjected to peer review. In individual studies, there was some favorable effect with fludrocortisone, beta blockers, midodrine, and selective serotonin reuptake inhibitors. Conclusion: There is a paucity of high-quality data about effectiveness of medication in the treatment of postural orthostatic tachycardia syndrome. Nonetheless, 2 randomized trials and 6 other reports show some favorable effects of medication.

Download Full-text

Can Psychological Interventions Reduce Perfectionism? A Systematic Review and Meta-analysis

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465814000162 ◽

2014 ◽

Vol 43 (6) ◽

pp. 705-731 ◽

Cited By ~ 74

Author(s):

Samantha Lloyd ◽

Ulrike Schmidt ◽

Mizanur Khondoker ◽

Kate Tchanturia

Keyword(s):

Systematic Review ◽

Psychiatric Disorders ◽

Meta Analysis ◽

The Self ◽

Effect Sizes ◽

Psychological Interventions ◽

Personal Standards ◽

Socially Prescribed Perfectionism ◽

Concern Over Mistakes ◽

Meta Analyses

Background:Perfectionism is implicated in a range of psychiatric disorders, impedes treatment and is associated with poorer treatment outcomes.Aims:The aim of this systematic review and meta-analysis was to summarize the existing evidence for psychological interventions targeting perfectionism in individuals with psychiatric disorders associated with perfectionism and/or elevated perfectionism.Method: Eight studies were identified and were analysed in meta-analyses. Meta-analyses were carried out for the Personal Standards and Concern over Mistakes subscales of the Frost Multi-Dimensional Perfectionism Scale (FMPS) and the Self Orientated Perfectionism and Socially Prescribed Perfectionism subscales of the Hewitt and Flett MPS (HMPS) in order to investigate change between pre and postintervention.Results:Large pooled effect sizes were found for the Personal Standards and Concern over Mistakes subscales of the FMPS and the Self Orientated Perfectionism subscale of the HMPS, whilst a medium sized effect was found for change in Socially Prescribed Perfectionism. Medium pooled effect sizes were also found for symptoms of anxiety and depression.Conclusions:There is some support that it is possible to significantly reduce perfectionism in individuals with clinical disorders associated with perfectionism and/or clinical levels of perfectionism. There is also some evidence that such interventions are associated with decreases in anxiety, depression, eating disorder and obsessive compulsive symptoms. Further research is needed in order to investigate the optimal dosage and format of such interventions as well as into specific disorders where there is a lack of evidence for their effectiveness.

Download Full-text

Psychological distress and psychiatric disorder after natural disasters: systematic review and meta-analysis

The British Journal of Psychiatry ◽

10.1192/bjp.2018.210 ◽

2018 ◽

Vol 213 (6) ◽

pp. 716-722 ◽

Cited By ~ 41

Author(s):

Ben Beaglehole ◽

Roger T. Mulder ◽

Chris M. Frampton ◽

Joseph M. Boden ◽

Giles Newton-Howes ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Psychological Distress ◽

Psychiatric Disorder ◽

Natural Disasters ◽

Psychiatric Disorders ◽

Meta Analysis ◽

Quality Criteria ◽

Post Traumatic Stress ◽

Meta Analyses

BackgroundNatural disasters are increasing in frequency and severity. They cause widespread hardship and are associated with detrimental effects on mental health.AimsOur aim is to provide the best estimate of the effects of natural disasters on mental health through a systematic review and meta-analysis of the rates of psychological distress and psychiatric disorder after natural disasters.MethodThis systematic review and meta-analysis is limited to studies that met predetermined quality criteria. We required included studies to make comparisons with pre-disaster or non-disaster exposed controls, and sample representative populations. Key studies were identified through a comprehensive search of PubMed, EMBASE and PsycINFO from 1980 to 3 March 2017. Random effects meta-analyses were performed for studies that reported key outcomes with appropriate statistics.ResultsForty-one studies were identified by the literature search, of which 27 contributed to the meta-analyses. Continuous measures of psychological distress were increased after natural disasters (combined standardised mean difference 0.63, 95% CI 0.27–0.98, P = 0.005). Psychiatric disorders were also increased (combined odds ratio 1.84, 95% CI 1.43–2.38, P < 0.001). Rates of post-traumatic stress disorder and depression were significantly increased after disasters. Findings for anxiety and alcohol misuse/dependence were not significant. High rates of heterogeneity suggest that disaster-specific factors and, to a lesser degree, methodological factors contribute to the variance between studies.ConclusionsIncreased rates of psychological distress and psychiatric disorders follow natural disasters. High levels of heterogeneity between studies suggest that disaster variables and post-disaster response have the potential to mitigate adverse effects.Declaration of interestNone.

Download Full-text

Dialectical Behaviour Therapy as a Transdiagnostic Treatment for Common Psychiatric Disorders: Study Protocol for a Systematic Review

10.21203/rs.3.rs-144658/v1 ◽

2021 ◽

Author(s):

Michelle Yan Ling Tan ◽

Bridget McConnell ◽

Joanna Barlas

Keyword(s):

Systematic Review ◽

Psychiatric Disorders ◽

Systematic Reviews ◽

Meta Analysis ◽

Behaviour Therapy ◽

Dialectical Behaviour Therapy ◽

Transdiagnostic Treatment ◽

Clinical Presentations ◽

Psychiatric Conditions ◽

Meta Analyses

Abstract BackgroundDialectical Behaviour Therapy (DBT) is one of the most well-known interventions for treating Borderline Personality Disorder, but has been increasingly adapted for use with other psychiatric disorders. Standard DBT consists of four treatment modes, delivered over the course of a full year. Adaptations made to DBT to suit other patient populations include changes to modes of delivery, treatment length, and other components such as skills modules taught to patients. In some cases, interventions from other evidence-based therapies for specific presenting problems or clinical concerns are incorporated into the treatment. This study aims to synthesize the existing evidence on DBT as a treatment for various types of psychiatric conditions.MethodsA systematic review and planned meta-analysis will be conducted according to the procedures outlined in the Cochrane Handbook for Systematic Reviews of Interventions (Higgins et al., 2019). Outcomes will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Moher et al., 2009). A search strategy was devised to combine domains of various clinical presentations and the treatment approach (i.e., DBT).DiscussionResults from this study will deepen understanding of the effectiveness of DBT in treating various psychiatric conditions, and the clinical populations with which it would be most appropriate for use.Systematic review registrationPROSPERO, CRD42020168550

Download Full-text

The empirical support for mindfulness-based interventions for common psychiatric disorders: a systematic review and meta-analysis

Psychological Medicine ◽

10.1017/s0033291718000259 ◽

2018 ◽

Vol 48 (13) ◽

pp. 2116-2129 ◽

Cited By ~ 20

Author(s):

Maria Hedman-Lagerlöf ◽

Erik Hedman-Lagerlöf ◽

Lars-Göran Öst

Keyword(s):

Systematic Review ◽

Psychiatric Disorders ◽

Acute Phase ◽

Methodological Quality ◽

Common Mental Disorders ◽

Meta Analysis ◽

Empirical Support ◽

Evidence Base ◽

Treatment As Usual ◽

Literature Searches

AbstractMindfulness-based interventions (MBIs) have become widely used for common mental disorders (CMDs) but the state of the evidence has not been sufficiently investigated. The aims for this study were: (1) to quantify the effect size of MBIs for CMDs in the acute phase; (2) to explore moderator variables; and (3) to evaluate the evidence status of MBIs for the CMDs it has been tried for. A comprehensive systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted. RCTs that evaluated MBI and included patients with a primary manifest CMD was included. Methodological quality, the risk of bias, publication bias and evidence status were assessed. Literature searches gave 2448 hits and 19 studies were included. MBIs were more effective than no treatment (g = 1.07) and treatment-as-usual (g = 0.40) but not in comparison to placebo (g = 0.17) or other active treatments (g = −0.01). Methodological quality was negatively correlated with outcome. For all psychiatric disorders it has been tested, MBIs were judged to have weak or no empirical support. The conclusion of the study is that the evidence-base for MBIs for CMDs in the acute phase is weak.

Download Full-text

Impact of Chemotherapy in the Adjuvant Setting of Early Stage Uterine Leiomyosarcoma: A Systematic Review and Updated Meta-Analysis

Cancers ◽

10.3390/cancers12071899 ◽

2020 ◽

Vol 12 (7) ◽

pp. 1899

Author(s):

Alessandro Rizzo ◽

Margherita Nannini ◽

Annalisa Astolfi ◽

Valentina Indio ◽

Pierandrea De Iaco ◽

...

Keyword(s):

Systematic Review ◽

Recurrence Rate ◽

Locoregional Recurrence ◽

Early Stage ◽

Meta Analysis ◽

Distant Recurrence ◽

Uterine Leiomyosarcoma ◽

Primary Surgery ◽

Locoregional Recurrence Rate ◽

Meta Analyses

Background: Although the use of adjuvant chemotherapy (AC) appears to be increasing over the past few years, several clinical trials and previous meta-analyses failed to determine whether AC could improve clinical outcomes in uterine leiomyosarcoma (uLMS). The aim of this systematic review and meta-analysis was to compare AC (with or without radiotherapy) versus observation (obs) after primary surgery in early stage uLMS. Materials and Methods: Randomized controlled (RCTs) and non-randomized studies (NRSs) were retrieved. Outcomes of interest were as follows: distant recurrence rate, locoregional recurrence rate and overall recurrence rate. Results about distant recurrence rate, locoregional recurrence rate and overall recurrence rate were compared by calculating odds ratios (ORs) with 95% confidence intervals (CIs); ORs were combined with Mantel–Haenszel method. Results: Nine studies were included in the analysis, involving 545 patients (AC: 252, obs: 293). Compared with obs, AC did not reduce locoregional and distant recurrence rate, with a pooled OR of 1.36 and 0.63, respectively. Similarly, administration of AC did not decrease overall recurrence rate in comparison to obs. Conclusion: According to our results, AC (with or without radiotherapy) did not decrease recurrence rate in early stage uLMS; thus, the role of AC in this setting remains unclear.

Download Full-text

Systematic Review: Allogenic Use of Stromal Vascular Fraction (SVF) and Decellularized Extracellular Matrices (ECM) as Advanced Therapy Medicinal Products (ATMP) in Tissue Regeneration

International Journal of Molecular Sciences ◽

10.3390/ijms21144982 ◽

2020 ◽

Vol 21 (14) ◽

pp. 4982 ◽

Cited By ~ 1

Author(s):

Pietro Gentile ◽

Aris Sterodimas ◽

Jacopo Pizzicannella ◽

Laura Dionisi ◽

Domenico De Fazio ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Stromal Vascular Fraction ◽

Lateral Epicondylitis ◽

Medicinal Products ◽

Advanced Therapy Medicinal Products ◽

Advanced Therapy ◽

Meta Analyses ◽

Clinical Experiments

Stromal vascular fraction (SVF) containing adipose stem cells (ASCs) has been used for many years in regenerative plastic surgery for autologous applications, without any focus on their potential allogenic role. Allogenic SVF transplants could be based on the possibility to use decellularized extracellular matrix (ECM) as a scaffold from a donor then re-cellularized by ASCs of the recipient, in order to develop the advanced therapy medicinal products (ATMP) in fully personalized clinical approaches. A systematic review of this field has been realized in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses-Protocols (PRISMA-P) guidelines. Multistep research of the PubMed, Embase, MEDLINE, Pre-MEDLINE, PsycINFO, CINAHL, Clinicaltrials.gov, Scopus database, and Cochrane databases has been conducted to identify articles and investigations on human allogenic ASCs transplant for clinical use. Of the 341 articles identified, 313 were initially assessed for eligibility on the basis of the abstract. Of these, only 29 met all the predetermined criteria for inclusion according to the PICOS (patients, intervention, comparator, outcomes, and study design) approach, and 19 have been included in quantitative synthesis (meta-analysis). Ninety-one percent of the studies previously screened (284 papers) were focused on the in vitro results and pre-clinical experiments. The allogenic use regarded the treatment of perianal fistulas, diabetic foot ulcers, knee osteoarthritis, acute respiratory distress syndrome, refractory rheumatoid arthritis, pediatrics disease, fecal incontinence, ischemic heart disease, autoimmune encephalomyelitis, lateral epicondylitis, and soft tissue defects. The information analyzed suggested the safety and efficacy of allogenic ASCs and ECM transplants without major side effects.

Download Full-text