Use of Causal Language in Studies on the Relationship between Spiritually-Based Treatments and Substance Abuse and Relapse Prevention

The main goal of scientific research is to explain what causes a phenomenon. However, only well-controlled studies guarantee sufficient internal validity to support causal explanations (i.e., experimental and some quasi-experimental designs). The use of causal claims in non-experimental studies can mislead readers into assuming a cause–effect relationship when alternative explanations have not been ruled out, undermining the principle of scientific rigor and the credibility of scientific findings. Although spiritual practices form part of some interventions for health and behavioral problems, their effectiveness cannot often be assessed via experimental methodology. This paper assesses the validity of causal inferences in published non-experimental studies, and more specifically in studies on the relationship between spiritually based treatments and substance abuse improvement and relapse prevention. We conducted a systematic review using Scopus, Pubmed, and several databases included in ProQuest, for the period 2015 to 2020. Out of 16 studies selected, six studies (37.5%) used correct language in the title, abstract, and discussion sections; 10 studies (68.8%) used tendentious or incorrect language in at least one section. Spiritually based treatments show promising results in some health improvement outcomes. Most studies show transparency when reporting results. However, researchers should be careful not to make causal assertions unless the internal validity of the research is sound.

Relapse activity in the chronic phase of anti-myelin-oligodendrocyte glycoprotein antibody-associated disease

Objective The patterns of relapse and relapse-prevention strategies for anti-myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are not completely investigated. We compared the patterns of relapse in later stages of MOGAD with those of anti-aquaporin-4 antibody (AQP4-Ab)-positive neuromyelitis optica spectrum disorder (NMOSD). Methods In this observational, comparative cohort study, 66 patients with MOGAD and 90 with AQP4-Ab-positive NMOSD were enrolled. We compared the patterns of relapse and annualized relapse rates (ARRs) in the first 10 years from disease onset, stratified by relapse-prevention treatments. Results Approximately 50% of the patients with MOGAD experienced relapses in the first 10 years. Among those not undergoing relapse-prevention treatments, ARRs in the first 5 years were slightly lower in MOGAD patients than in AQP4-Ab-positive NMOSD patients (MOGAD vs. AQP4-Ab NMOSD: 0.19 vs. 0.30; p = 0.0753). After 5 years, the ARR decreased in MOGAD patients (MOGAD vs. AQP4-Ab NMOSD: 0.05 vs. 0.34; p = 0.0001), with a 72% reduction from the first 5 years (p = 0.0090). Eight (61.5%) of the 13 MOGAD patients with more than 10-year follow-up from disease onset showed relapse 10 years after onset. Clustering in the timing and phenotype of attacks was observed in both disease patients. The effectiveness of long-term low-dose oral PSL for relapse prevention in patients with MOGAD has not been determined. Conclusions The relapse risk in patients with MOGAD is generally lower than that in patients with AQP4-Ab-positive NMOSD, especially 5 years after onset. Meanwhile, relapses later than 10 years from onset are not rare in both diseases.

Electroconvulsive therapy: a clinical case study and review

Electroconvulsive therapy is deemed one of the most effective treatments for alleviating symptoms in individuals diagnosed with severe depression, yet it remains one of the most controversial psychiatric treatments in contemporary mental health nursing practice. As such, its use and efficacy continue to be questioned. The following article analyses the case of Albert, a fictional character who represents the presentation of several patients who have received electroconvulsive therapy. The application of electroconvulsive therapy is evaluated, by referring to the most recent policy and national guidelines. Despite the associated stigma, electroconvulsive therapy can save lives, as portrayed by Albert. However, further research is required and updated guidance from National Institute for Health and Care Excellence is needed, specifically with regards to maintenance and relapse prevention. It is important to be aware of the implications of side effects, just as with other interventions. Overall, this article highlights the importance of safe, recovery-focused and person-centred care.