scholarly journals The efficacy and safety of nutrient supplements in the treatment of mental disorders: a meta‐review of meta‐analyses of randomized controlled trials

2019 ◽  
Vol 18 (3) ◽  
pp. 308-324 ◽  
Author(s):  
Joseph Firth ◽  
Scott B. Teasdale ◽  
Kelly Allott ◽  
Dan Siskind ◽  
Wolfgang Marx ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Nutrient Supplements ◽  
Meta Review ◽  
Meta Analyses

Plant-based Medicines (Phytoceuticals) in the Treatment of Psychiatric Disorders: A Meta-review of Meta-analyses of Randomized Controlled Trials: Les médicaments à base de plantes (phytoceutiques) dans le traitement des troubles psychiatriques: une méta-revue des méta-analyses d’essais randomisés contrôlés

2021 ◽  
pp. 070674372097991
Author(s):  
Jerome Sarris ◽  
Wolfgang Marx ◽  
Melanie M. Ashton ◽  
Chee H. Ng ◽  
Nicole Galvao-Coelho ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Psychiatric Disorders ◽  
Publication Bias ◽  
Negative Symptoms ◽  
Depression Symptoms ◽  
Controlled Trials ◽  
Traditional Chinese Herbal Medicine ◽  
Randomized Controlled ◽  
Meta Review ◽  
Meta Analyses

Objectives: Plant-based medicines have had a long-standing history of use in psychiatric disorders. Highly quantified and standardized extracts or isolates may be termed “phytoceuticals,” in a similar way that medicinal nutrients are termed as “nutraceuticals.” Over the past 2 decades, several meta-analyses have examined the data for a range of plant-based medicines in the treatment of psychiatric disorders. The aim of this international project is to provide a “meta-review” of this top-tier evidence. Methods: We identified, synthesized, and appraised all available up to date meta-analyses... of randomized controlled trials (RCTs) reporting on the efficacy and effectiveness of individual phytoceuticals across all major psychiatric disorders. Results: Our systematic search identified 9 relevant meta-analyses of RCTs, with primary analyses including outcome data from 5,927 individuals. Supportive meta-analytic evidence was found for St John’s wort for major depressive disorder (MDD); curcumin and saffron for MDD or depression symptoms, and ginkgo for total and negative symptoms in schizophrenia. Kava was not effective in treating diagnosed anxiety disorders. We also provide details on 22 traditional Chinese herbal medicine formulas’ meta-analyses (primarily for depression studies), all of which revealed highly significant and large effect sizes. Their methodology, reporting, and potential publication bias were, however, of marked concern. The same caveat was noted for the curcumin, ginkgo, and saffron meta-analyses, which may also have significant publication bias. Conclusions: More rigorous international studies are required to validate the efficacy of these phytoceuticals before treatment recommendations can be made. In conclusion, the breadth of data tentatively supports several phytoceuticals which may be effective for mental disorders alongside pharmaceutical, psychological therapies, and standard lifestyle recommendations.

scholarly journals Mobile phone-based interventions for mental health-A systematic meta-review of 14 meta-analyses of randomized controlled trials

2021 ◽  
Author(s):  
Simon Goldberg ◽  
Sin U Lam ◽  
Otto Simonsson ◽  
John Torous ◽  
Shufang Sun
Keyword(s):  
Randomized Controlled Trials ◽  
Mobile Phone ◽  
Publication Bias ◽  
Convincing Evidence ◽  
Effect Sizes ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Suggestive Evidence ◽  
Meta Review ◽  
Meta Analyses

Mobile phone-based interventions have been proposed as a means for reducing the burden of disease associated with mental illness. While numerous randomized controlled trials and meta-analyses have investigated this possibility, evidence remains unclear. We conducted a systematic meta-review of meta-analyses examining mobile phone-based interventions tested in randomized controlled trials. We synthesized results from 14 meta-analyses representing 145 randomized controlled trials and 47,940 participants. We identified 34 effect sizes representing unique pairings of participants, intervention, comparisons, and outcome (PICO) and graded the strength of the evidence as using umbrella review methodology. We failed to find convincing evidence of efficacy (i.e., n > 1000, p < 10-6, I2 < 50%, absence of publication bias); publication bias was rarely assessed for the representative effect sizes. Eight effect sizes provided highly suggestive evidence (i.e., n > 1000, p < 10-6), including smartphone interventions outperforming inactive controls on measures of psychological symptoms and quality of life (ds = 0.32 to 0.47) and text message-based interventions outperforming non-specific controls and active controls for smoking cessation (ds = 0.31 and 0.19, respectively). The magnitude of effects and strength of evidence tended to diminish as comparison conditions became more rigorous (i.e., inactive to active, non-specific to specific). Four effect sizes provided suggestive evidence, 14 effect sizes provided weak evidence, and eight effect sizes were non-significant. Despite substantial heterogeneity, no moderators were identified. Adverse effects were not reported. Taken together, results support the potential of mobile phone-based interventions and highlight key directions to guide providers, policy makers, clinical trialists, and meta-analysts working in this area.

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