scholarly journals Music Therapy as Treatment of Negative Symptoms for Adult Patients Diagnosed with Schizophrenia—Study Protocol for a Randomized, Controlled and Blinded Study

Medicines ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. 46
Author(s):  
Inge Pedersen ◽  
Lars Bonde ◽  
Niels Hannibal ◽  
Jimmy Nielsen ◽  
Jørgen Aagaard ◽  
...  
Keyword(s):  
Music Therapy ◽  
Psychosocial Functioning ◽  
Negative Symptoms ◽  
National Board ◽  
Randomized Controlled ◽  
System A ◽  
Cochrane Reviews ◽  
Danish Health ◽  
Icd 10 ◽  
General Functioning

Background: Three Cochrane reviews show that music therapy has a positive effect on schizophrenia concerning general functioning and positive/negative symptoms. This study aims to replicate these results in the Danish health system, a requirement for recommendation in guidelines from the Danish National Board of Health. Methods: The study is a randomized, controlled multi-site study, with a blinded design, aiming to include 90 participants who are 18–65 years in age, diagnosed according to ICD-10 with a schizophrenia diagnosis. The participants are randomized to one of two different music therapy activities for 25 weekly sessions. The study interventions are added to standard care. Outcome measures are rated at baseline, after 15 sessions and post therapy. A qualitative interview is performed as a one month follow up at the end of study. The primary intended outcome is a reduction in negative symptoms. The secondary intended outcome is progression in quality of life, alliance and psychosocial functioning. Results: As this study is still running, the results are not yet available. Conclusion: The study will investigate the direct effects of music therapy on negative symptoms as part of schizophrenia in a blinded, randomized trial. If proven effective, music therapy can be added to the small treatment armamentarium of effective therapies for negative symptoms in patients with schizophrenia.

Effects of omega-3 polyunsaturated fatty acids supplements on psychopathology and metabolic parameters in schizophrenia: A meta-analysis of randomized controlled trials

2021 ◽  
Vol 35 (3) ◽  
pp. 221-235
Author(s):  
Kah K Goh ◽  
Cynthia Yi-An Chen ◽  
Chun-Hsin Chen ◽  
Mong-Liang Lu
Keyword(s):  
Fatty Acids ◽  
Polyunsaturated Fatty Acids ◽  
Randomized Controlled Trials ◽  
Negative Symptoms ◽  
Metabolic Parameters ◽  
Favorable Effect ◽  
Controlled Trials ◽  
Optimal Dosage ◽  
Omega 3 ◽  
Randomized Controlled

Background: Several monotherapy and augmentation strategies have been introduced to improve the treatment of schizophrenia. The benefits of omega-3 polyunsaturated fatty acids in patients with mental disorders is becoming increasingly acknowledged. However, its role in the treatment of schizophrenia raises complex considerations about which there has been little consensus. The aim of this study was to synthesize the findings of randomized controlled trials that were conducted to determine the efficacy and safety of omega-3 polyunsaturated fatty acids in patients with schizophrenia. Methods: The MEDLINE, Embase, Cochrane, Scopus, and Web of Science databases were searched for relevant literature. The primary outcome was changes in psychopathology and the secondary outcomes were changes in metabolic parameters and safety profiles. Results: Twenty double-blind randomized controlled trials in 1494 patients were included. Omega-3 polyunsaturated fatty acids augmentation was associated with significantly improved psychopathology in patients with schizophrenia, particularly general psychopathology and positive symptoms but not negative symptoms. Patients who were severely ill and received omega-3 polyunsaturated fatty acids containing eicosapentaenoic acid >1 g/d showed significant improvement. A favorable effect of omega-3 polyunsaturated fatty acids supplements on serum triglycerides was also demonstrated. Omega-3 polyunsaturated fatty acids are well-tolerated and safe in patients with schizophrenia. Conclusions: These findings tentatively support the use of omega-3 polyunsaturated fatty acids as a potential augmentation strategy in schizophrenia. Further research in larger samples is warranted to clarify the optimal dosage and the correct proportions of omega-3 polyunsaturated fatty acids to administer, together with elucidation of the underlying mechanisms.

scholarly journals Concordance between systematic reviews of randomized controlled trials in assisted reproduction: an overview

2020 ◽  
Vol 2020 (4) ◽  
Author(s):  
Mariano Mascarenhas ◽  
Theodoros Kalampokas ◽  
Sesh Kamal Sunkara ◽  
Mohan S Kamath
Keyword(s):  
Assisted Reproduction ◽  
Systematic Reviews ◽  
Selective Reporting ◽  
Methodological Issues ◽  
Quality Of Evidence ◽  
Randomized Controlled ◽  
Cochrane Reviews ◽  
Secondary Outcomes ◽  
Meta Analyses

Abstract STUDY QUESTION Are systematic reviews published within a 3-year period on interventions in ART concordant in their conclusions? SUMMARY ANSWER The majority of the systematic reviews published within a 3-year period in the field of assisted reproduction on the same topic had discordant conclusions. WHAT IS KNOWN ALREADY Systematic reviews and meta-analyses have now replaced individual randomized controlled trials (RCTs) at the top of the evidence pyramid. There has been a proliferation of systematic reviews and meta-analyses, many of which suffer from methodological issues and provide varying conclusions. STUDY DESIGN, SIZE, DURATION We assessed nine interventions in women undergoing ART with at least three systematic reviews each, published from January 2015 to December 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS The systematic reviews which included RCTs were considered eligible for inclusion. The primary outcome was extent of concordance between systematic reviews on the same topic. Secondary outcomes included assessment of quality of systematic reviews, differences in included studies in meta-analyses covering the same search period, selective reporting and reporting the quality of evidence. MAIN RESULTS AND THE ROLE OF CHANCE Concordant results and conclusions were found in only one topic, with reviews in the remaining eight topics displaying partial discordance. The AMSTAR grading for the majority of the non-Cochrane reviews was critically low whilst it was categorized as high for all of the Cochrane reviews. For three of the nine topics, none of the included systematic reviews assessed the quality of evidence. We were unable to assess selective reporting as most of the reviews did not have a pre-specified published protocol. LIMITATIONS, REASONS FOR CAUTION We were limited by the high proportion of reviews lacking a pre-specified protocol, which made it impossible to assess for selective reporting. Furthermore, many reviews did not specify primary and secondary outcomes which made it difficult to assess reporting bias. All the authors of this review were Cochrane review authors which may introduce some assessment bias. The categorization of the review’s conclusions as beneficial, harmful or neutral was subjective, depending on the tone and wording of the conclusion section of the review. WIDER IMPLICATIONS OF THE FINDINGS The majority of the systematic reviews published within a 3-year period on the same topic in the field of assisted reproduction revealed discordant conclusions and suffered from serious methodological issues, hindering the process of informed healthcare decision-making. STUDY FUNDING/COMPETING INTEREST(S) All the authors are Cochrane authors. M.S.K. is an editorial board member of Cochrane Gynaecology and Fertility group. No grant from funding agencies in the public, commercial or not-for-profit sectors was obtained.

scholarly journals Use of Composite Outcomes in Neonatal Trials: An Analysis of the Cochrane Reviews

Neonatology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Nai Ming Lai ◽  
Amanda Qiao Ying Yap ◽  
Hwee Chin Ong ◽  
Sheng Xuan Wai ◽  
Julie Hsiao Hui Yeo ◽  
...  
Keyword(s):  
Event Rate ◽  
A Priori ◽  
Effect Sizes ◽  
Common Component ◽  
Randomized Controlled ◽  
Cochrane Reviews ◽  
Contrasting Effect ◽  
Composite Outcomes ◽  
Event Rates ◽  
The Relationship

<b><i>Introduction:</i></b> Composite outcomes are used to increase the power of a study by combining event rates. Many composite outcomes in adult clinical trials have components that differ substantially in patient importance, event rate, and effect size, making interpretation challenging. Little is known about the use of composite outcomes in neonatal randomized controlled trials (RCTs). <b><i>Methods:</i></b> We assessed the use of composite outcomes in neonatal RCTs included in Cochrane Neonatal reviews published till November 2017. Two authors reviewed the components of the composite outcomes to compare their patient importance and computed the ratios of effect sizes and event rates between the components, with an a priori threshold of 1.5, indicating a substantial difference. Descriptive statistics were presented. <b><i>Results:</i></b> We extracted 7,766 outcomes in 2,134 RCTs in 312 systematic reviews. Among them, 55 composite outcomes (0.7%) were identified in 46 RCTs. The vast majority (92.7%) of composite outcomes had 2 components, with death being the most common component (included 51 times [92.7%]). The components in nearly three-quarters of the composite outcomes (<i>n</i> = 40 [72.7%]) had different patient importance, while the effect sizes and event rates differed substantially between the components in 27 (49.1%) and 35 (63.6%) outcomes, respectively, with up to 43-fold difference in the event rates observed. <b><i>Conclusions:</i></b> The majority of composite outcomes in neonatal RCTs had different patient importance with contrasting effect sizes and event rates between the components. In patient communication, clinicians should highlight individual components, rather than the composites, with explanation on the relationship between the components, to avoid misleading impression on the effect of the intervention. Future trials should report the estimates of all individual components alongside the composite outcomes presented.

Effect of Music on Pain in Cancer Patients in Palliative Care Service: A Randomized Controlled Study

2021 ◽  
pp. 003022282110598
Author(s):  
Gönül Düzgün ◽  
Ayfer Karadakovan
Keyword(s):  
Palliative Care ◽  
Music Therapy ◽  
Cancer Patients ◽  
Functional Capacity ◽  
Classical Music ◽  
Care Service ◽  
Palliative Care Service ◽  
Palliative Care Unit ◽  
Pain Anxiety ◽  
Randomized Controlled

This study aimed to investigate the effect of music on pain, anxiety, comfort, and functional capacity of cancer patients who received care in a palliative care unit. The population of this randomized controlled trial consisted of cancer patients hospitalized in the palliative care service between July 2018 and July 2019. The study included 60 patients (30 interventions/30 controls). The patients in the intervention group were given a total of six music sessions, 10 minutes each with the Turkish classical music in maqams of their choice (Hejaz or Rast accompanied by an expert tambour (drum) player). There was a significant difference between the mean total pain scores, anxiety, comfort, and functional capacity scores of the patients in the intervention and control groups before and after music therapy. Music therapy decreased the level of pain. It is demonstrated that Turkish classical music therapy improved the pain, anxiety, comfort, and functional capacity in the palliative care unit.

Predictors of quality of life and functioning in schizophrenia

2021 ◽  
Vol 25 (4) ◽  
pp. 341-356
Author(s):  
Octavia Căpățînă ◽  
◽  
Cristina Pojoga ◽  
Bogdan Savu ◽  
Mihaela Fadgyas-Stănculete ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Regression ◽  
Predictive Factors ◽  
Negative Symptoms ◽  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
Regression Analyses ◽  
Cross Sectional ◽  
General Functioning

Background: In order to pursue recovery, Quality of life (QoL) and general functioning in patients with schizophrenia are milestones that need to be addressed in the treatment of the disease. The major aim of the present study was to examine the relationship between QoL, functionality and symptoms, and clinical characteristics of the disease, and to identify whether the two domains of negative symptoms, avolition/apathy and diminished expression, are predictive factors for the quality of life and functionality in patients diagnosed with schizophrenia. In the present cross-sectional study, 87 patients diagnosed with schizophrenia completed a thorough battery of instruments evaluating: clinical symptoms, stigma, QoL, functionality, socio-demographic and clinical variables. Multiple regression analyses were performed to test the significance of predictor variables for QoL and functionality. Multiple regression analyses revealed that internalized stigma, depression, and excitement were significant predictors for the variability of QoL, and experiential deficit and cognitive symptoms were significant predictors of the variability of functioning. In patients with schizophrenia, functioning and quality of life are two related but different constructs. Even though they are strongly associated, they have different predictive factors. The clinical implication of these results is that both of these constructs should be assessed and that the strategies for improving them should be different.

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