eHealth Interventions for Treatment of Depression, Anxiety and Insomnia during Pregnancy: A Systematic Review and Meta-Analysis (Preprint)

2021 ◽  
Author(s):  
Katherine A. Silang ◽  
Pooja R. Sohal ◽  
Katherine Bright ◽  
Jennifer Leason ◽  
Leslie Roos ◽  
...  

BACKGROUND Pregnancy is associated with an increased risk for depression, anxiety and insomnia. eHealth interventions provide a promising and accessible treatment alternative to face-to-face intervention. OBJECTIVE The objective of this systematic review and meta-analysis was to determine the effectiveness of eHealth interventions to prevent and/or treat depression, anxiety and insomnia during pregnancy. Secondary aims were to identify demographic and intervention moderators of effectiveness. METHODS Five databases (PsycINFO, Medline, CINAHL, Embase, Cochrane) were searched from inception to May 2021. Terms related to eHealth, pregnancy, randomized controlled trials, depression, anxiety, and insomnia were included. RCTs were included if they reported (a) an eHealth intervention for (b) the prevention or treatment of depression, anxiety or insomnia (c) in pregnant women. Study screening, data extractions and quality assessment were conducted independently by two reviewers. Random effects meta-analyses of pooled effect sizes were conducted to determine the effect of eHealth interventions on prenatal mental health. Meta-regression analyses were conducted to identify potential moderators. RESULTS In total, 17 studies were included in the current review that assessed changes in depression (11), anxiety (n=10), and insomnia (n=3). Several studies included both depression and anxiety symptoms as outcomes (n=7). The results indicated that during pregnancy, eHealth interventions showed small effect sizes for preventing and treating symptoms of anxiety and depression and a moderate effect size for treating symptoms of insomnia. With the exception of intervention type for the outcome of depressive symptoms, where Mindfulness interventions outperformed other intervention types, no significant moderators were detected. CONCLUSIONS eHealth interventions are an accessible and promising resource for treating symptoms of anxiety, depression and insomnia during pregnancy. However, more research is necessary to identify ways to increase the efficacy of eHealth interventions for this population. CLINICALTRIAL The study was registered with PROSPERO through the University of York Center for Reviews and Dissemination (Registration No. CRD42020205186).

2021 ◽  
Vol 5 (1) ◽  
pp. e100135
Author(s):  
Xue Ying Zhang ◽  
Jan Vollert ◽  
Emily S Sena ◽  
Andrew SC Rice ◽  
Nadia Soliman

ObjectiveThigmotaxis is an innate predator avoidance behaviour of rodents and is enhanced when animals are under stress. It is characterised by the preference of a rodent to seek shelter, rather than expose itself to the aversive open area. The behaviour has been proposed to be a measurable construct that can address the impact of pain on rodent behaviour. This systematic review will assess whether thigmotaxis can be influenced by experimental persistent pain and attenuated by pharmacological interventions in rodents.Search strategyWe will conduct search on three electronic databases to identify studies in which thigmotaxis was used as an outcome measure contextualised to a rodent model associated with persistent pain. All studies published until the date of the search will be considered.Screening and annotationTwo independent reviewers will screen studies based on the order of (1) titles and abstracts, and (2) full texts.Data management and reportingFor meta-analysis, we will extract thigmotactic behavioural data and calculate effect sizes. Effect sizes will be combined using a random-effects model. We will assess heterogeneity and identify sources of heterogeneity. A risk-of-bias assessment will be conducted to evaluate study quality. Publication bias will be assessed using funnel plots, Egger’s regression and trim-and-fill analysis. We will also extract stimulus-evoked limb withdrawal data to assess its correlation with thigmotaxis in the same animals. The evidence obtained will provide a comprehensive understanding of the strengths and limitations of using thigmotactic outcome measure in animal pain research so that future experimental designs can be optimised. We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines and disseminate the review findings through publication and conference presentation.


2019 ◽  
Vol 55 ◽  
pp. 80-89 ◽  
Author(s):  
Emma Kinnaird ◽  
Catherine Stewart ◽  
Kate Tchanturia

AbstractBackground:New research suggests that, rather than representing a core feature of autism spectrum disorder (ASD), emotional processing difficulties reflect co-occurring alexithymia. Autistic individuals with alexithymia could therefore represent a specific subgroup of autism who may benefit from tailored interventions. The aim of this systematic review and meta-analysis was to explore the nature and prevalence of alexithymia in autism using the Toronto Alexithymia Scale (TAS).Methods:Online scientific databases were searched systematically for studies on ASD popu lations using the TAS. Meta-analyses were performed to evaluate differences in scores between the ASD and neurotypical groups, and to determine the prevalence of alexithymia in these populations.Results:15 articles comparing autistic and neurotypical (NT) groups were identified. Autistic people scored significantly higher on all scores compared to the NT group. There was also a higher prevalence of alexithymia in the ASD group (49.93% compared to 4.89%), with a significantly increased risk of alexithymia in autistic participants.Conclusions:This review highlights that alexithymia is common, rather than universal, in ASD, supporting a growing body of evidence that co-occurring autism and alexithymia represents a specific subgroup in the ASD population that may have specific clinical needs. More research is needed to understand the nature and implications of co-occurring ASD and alexithymia.


2019 ◽  
Vol 12 (5) ◽  
pp. 373-402 ◽  
Author(s):  
Sakineh Hajebrahimi ◽  
Ali Janati ◽  
Morteza Arab-Zozani ◽  
Mobin Sokhanvar ◽  
Elaheh Haghgoshayie ◽  
...  

Purpose Visit time is a crucial aspect of patient–physician interaction; its inadequacy can negatively impact the efficiency of treatment and diagnosis. In addition, visit time is a fundamental demand of patients, and it is one of the rights of every patient. The purpose of this paper is to determine factors influencing the consultation length of physicians and to compare consultation length in different countries. Design/methodology/approach MEDLINE (PubMed), Web of Science, Cochrane, ProQuest, Scopus, and Google Scholar were searched. In addition, references of references were checked, and publication lists of individual scholars in the field were examined. We used data sources up to June 2018, without language restriction. We used a random-effects model for the meta-analyses. Meta-analyses were conducted using Comprehensive Meta-Analysis Version (CMA) 3.0. Findings Of 16,911 identified studies, 189 studies were assessed of which 125 cases (67 percent) have been conducted in the USA. A total of 189 studies, 164 (86.77 percent) involved face-to face-consultations. The effects of three variables, physician gender, patient gender, and type of consultation were analyzed. According to moderate and strong evidence studies, no significant difference was found in the consultation lengths of female and male doctors (Q=42.72, df=8, I2=81.27, p=0.891) and patients’ gender (Q=55.98, df=11, I2=80.35, p=0.314). In addition, no significant difference was found in the telemedicine or face-to-face visits (Q=41.25, df=5, I2=87.88, p=0.170). Originality/value In this systematic review and meta-analysis, all of physicians’ visits in 34 countries were surveyed. The evidence suggests that specified variables do not influence the length of consultations. Good relationship is essential to a safe and high-quality consultation and referral process. A high-quality consultation can improve decisions and quality of visits, treatment effectiveness, efficiency of service, quality of care, patient safety and physician and patient satisfaction.


2020 ◽  
pp. 027112142093557 ◽  
Author(s):  
Li Luo ◽  
Brian Reichow ◽  
Patricia Snyder ◽  
Jennifer Harrington ◽  
Joy Polignano

Background: All children benefit from intentional interactions and instruction to become socially and emotionally competent. Over the past 30 years, evidence-based intervention tactics and strategies have been integrated to establish comprehensive, multitiered, or hierarchical systems of support frameworks to guide social–emotional interventions for young children. Objectives: To review systematically the efficacy of classroom-wide social–emotional interventions for improving the social, emotional, and behavioral outcomes of preschool children and to use meta-analytic techniques to identify critical study characteristics associated with obtained effect sizes. Method: Four electronic databases (i.e., Academic Search Premier, Educational Resource Information Center, PsycINFO, and Education Full Text) were systematically searched in December 2015 and updated in January 2018. “Snowball methods” were used to locate additional relevant studies. Effect size estimates were pooled using random-effects meta-analyses for three child outcomes, and moderator analyses were conducted. Results: Thirty-nine studies involving 10,646 child participants met the inclusion criteria and were included in this systematic review, with 33 studies included in the meta-analyses. Random-effects meta-analyses showed improvements in social competence ( g = 0.42, 95% confidence interval [CI] = [0.28, 0.56]) and emotional competence ( g = 0.33, 95% CI = [0.10, 0.56]), and decreases in challenging behavior ( g = −0.31, 95% CI = [−0.43, −0.19]). For social competence and challenging behavior, moderator analyses suggested interventions with a family component had statistically significant and larger effect sizes than those without a family component. Studies in which classroom teachers served as the intervention agent produced statistically significant but smaller effect sizes than when researchers or others implemented the intervention for challenging behavior. Conclusion: This systematic review and meta-analysis support using comprehensive social–emotional interventions for all children in a preschool classroom to improve their social–emotional competence and reduce challenging behavior.


Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 964 ◽  
Author(s):  
Victoria Villegas-Navas ◽  
Maria-Jose Montero-Simo ◽  
Rafael A. Araque-Padilla

While watching or playing with media, children are often confronted with food appearances. These food portrayals might be a potential factor that affects a child’s dietary behaviors. We aimed to comprehensively expound the effects of these types of food appearances on dietary outcomes of children. Our objectives were to synthetize the evidence of the experiments that study the effects of foods embedded in children’s entertainment media throughout a systematic review, to conduct two meta-analyses (food choice and intake) in order to quantify the effects, and to examine to what extent the effects of foods embedded in entertainment media varies across different moderating variables. We conducted a systematic search of five databases for studies published up to July 2018 regarding terms related to children and foods embedded in entertainment media. We identified 26 eligible articles, of which 13 (20 effect sizes) and 7 (13 effect sizes) were considered for a meta-analysis on food choice and intake, respectively. Most of the studies were assessed as having a middle risk of bias. Overall, food being embedded in entertainment media is a strategy that affects the eating behaviors of children. As most of the embedded foods in the included studies had low nutritional values, urgent measures are needed to address the problem of childhood obesity.


Nutrients ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 142 ◽  
Author(s):  
Emma Clappison ◽  
Marios Hadjivassiliou ◽  
Panagiotis Zis

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.


BMJ ◽  
2020 ◽  
pp. l7078 ◽  
Author(s):  
Joshua D Wallach ◽  
Kun Wang ◽  
Audrey D Zhang ◽  
Deanna Cheng ◽  
Holly K Grossetta Nardini ◽  
...  

AbstractObjectivesTo conduct a systematic review and meta-analysis of the effects of rosiglitazone treatment on cardiovascular risk and mortality using multiple data sources and varying analytical approaches with three aims in mind: to clarify uncertainties about the cardiovascular risk of rosiglitazone; to determine whether different analytical approaches are likely to alter the conclusions of adverse event meta-analyses; and to inform efforts to promote clinical trial transparency and data sharing.DesignSystematic review and meta-analysis of randomized controlled trials.Data sourcesGlaxoSmithKline’s (GSK’s) ClinicalStudyDataRequest.com for individual patient level data (IPD) and GSK’s Study Register platforms, MEDLINE, PubMed, Embase, Web of Science, Cochrane Central Registry of Controlled Trials, Scopus, and ClinicalTrials.gov from inception to January 2019 for summary level data.Eligibility criteria for selecting studiesRandomized, controlled, phase II-IV clinical trials that compared rosiglitazone with any control for at least 24 weeks in adults.Data extraction and synthesisFor analyses of trials for which IPD were available, a composite outcome of acute myocardial infarction, heart failure, cardiovascular related death, and non-cardiovascular related death was examined. These four events were examined independently as secondary analyses. For analyses including trials for which IPD were not available, myocardial infarction and cardiovascular related death were examined, which were determined from summary level data. Multiple meta-analyses were conducted that accounted for trials with zero events in one or both arms with two different continuity corrections (0.5 constant and treatment arm) to calculate odds ratios and risk ratios with 95% confidence intervals.Results33 eligible trials were identified from ClinicalStudyDataRequest.com for which IPD were available (21 156 patients). Additionally, 103 trials for which IPD were not available were included in the meta-analyses for myocardial infarction (23 683 patients), and 103 trials for which IPD were not available contributed to the meta-analyses for cardiovascular related death (22 772 patients). Among 29 trials for which IPD were available and that were included in previous meta-analyses using GSK’s summary level data, more myocardial infarction events were identified by using IPD instead of summary level data for 26 trials, and fewer cardiovascular related deaths for five trials. When analyses were limited to trials for which IPD were available, and a constant continuity correction of 0.5 and a random effects model were used to account for trials with zero events in only one arm, patients treated with rosiglitazone had a 33% increased risk of a composite event compared with controls (odds ratio 1.33, 95% confidence interval 1.09 to 1.61; rosiglitazone population: 274 events among 11 837 patients; control population: 219 events among 9319 patients). The odds ratios for myocardial infarction, heart failure, cardiovascular related death, and non-cardiovascular related death were 1.17 (0.92 to 1.51), 1.54 (1.14 to 2.09), 1.15 (0.55 to 2.41), and 1.18 (0.60 to 2.30), respectively. For analyses including trials for which IPD were not available, odds ratios for myocardial infarction and cardiovascular related death were attenuated (1.09, 0.88 to 1.35, and 1.12, 0.72 to 1.74, respectively). Results were broadly consistent when analyses were repeated using trials with zero events across both arms and either of the two continuity corrections was used.ConclusionsThe results suggest that rosiglitazone is associated with an increased cardiovascular risk, especially for heart failure events. Although increased risk of myocardial infarction was observed across analyses, the strength of the evidence varied and effect estimates were attenuated when summary level data were used in addition to IPD. Because more myocardial infarctions and fewer cardiovascular related deaths were reported in the IPD than in the summary level data, sharing IPD might be necessary when performing meta-analyses focused on safety.Systematic review registrationOSF Home https://osf.io/4yvp2/.


2015 ◽  
Vol 46 (2) ◽  
pp. 237-251 ◽  
Author(s):  
S. Honings ◽  
M. Drukker ◽  
R. Groen ◽  
J. van Os

BackgroundRecent studies suggest that psychotic experiences (PE) in the general population are associated with an increased risk of self-injurious behaviour. Both the magnitude of this association and the level of adjustment for confounders vary among studies. A meta-analysis was performed to integrate the available evidence. The influence of possible confounders, including variably defined depression, was assessed.MethodA systematic review and meta-analysis was conducted including general population studies reporting on the risk of self-injurious behaviour in individuals with PE. Studies were identified by a systematic search strategy in Pubmed, PsycINFO and Embase. Reported effect sizes were extracted and meta-analytically pooled.ResultsThe risk of self-injurious behaviour was 3.20 times higher in individuals with PE compared with those without. Subanalyses showed that PE were associated with self-harm, suicidal ideation as well as suicidal attempts. All studies had scope for considerable residual confounding; effect sizes adjusted for depression were significantly smaller than effect sizes unadjusted for depression. In the longitudinal studies, adjustment for psychopathology resulted in a 74% reduction in excess risk.ConclusionsPE are associated with self-injurious behaviour, suggesting they have potential as passive markers of suicidality. However, the association is confounded and several methodological issues remain, particularly how to separate PE from the full range of connected psychopathology in determining any specific association with self-injurious behaviour. Given evidence that PE represent an indicator of severity of non-psychotic psychopathology, the association between PE and self-injurious behaviour probably reflects a greater likelihood of self-injurious behaviour in more severe states of mental distress.


2015 ◽  
Vol 24 (2) ◽  
pp. 237-255 ◽  
Author(s):  
Patricia L. Cleave ◽  
Stephanie D. Becker ◽  
Maura K. Curran ◽  
Amanda J. Owen Van Horne ◽  
Marc E. Fey

Purpose This systematic review and meta-analysis critically evaluated the research evidence on the effectiveness of conversational recasts in grammatical development for children with language impairments. Method Two different but complementary reviews were conducted and then integrated. Systematic searches of the literature resulted in 35 articles for the systematic review. Studies that employed a wide variety of study designs were involved, but all examined interventions where recasts were the key component. The meta-analysis only included studies that allowed the calculation of effect sizes, but it did include package interventions in which recasts were a major part. Fourteen studies were included, 7 of which were also in the systematic review. Studies were grouped according to research phase and were rated for quality. Results Study quality and thus strength of evidence varied substantially. Nevertheless, across all phases, the vast majority of studies provided support for the use of recasts. Meta-analyses found average effect sizes of .96 for proximal measures and .76 for distal measures, reflecting a positive benefit of about 0.75 to 1.00 standard deviation. Conclusion The available evidence is limited, but it is supportive of the use of recasts in grammatical intervention. Critical features of recasts in grammatical interventions are discussed.


CNS Spectrums ◽  
2009 ◽  
Vol 14 (S3) ◽  
pp. 34-40 ◽  
Author(s):  
Edith van‘t Hof ◽  
Pim Cuijpers ◽  
Dan J. Stein

AbstractThere is a growing database of research on self-help and Internet-guided interventions in the treatment of common mental disorders, and a number of meta-analyses have now been published. This article provides a systematic review of meta-analyses on the efficacy of self-help interventions, including Internet-guided therapy, for depression and anxiety disorders. Searches were conducted in PubMed, PsychINFO, EMBASE, and the Cochrane database for statistical meta-analyses of randomized, controlled trials of self-help or Internet-guided interventions for depression or anxiety disorders published in English. Reference lists were also used to find additional studies. Effect sizes were tabulated; 13 meta-analyses reported medium to large effect sizes for self-help interventions. Studies included in the meta-analyses differed in samples, type of self-help (eg, computer-aided, Internet-guided), control conditions, and study design. The meta-analyses indicate that self-help methods are effective in a range of different disorders, including depression and anxiety disorders. Most meta-analyses found relatively large effect sizes for self-help treatments, independent of the type of self-help, and comparable to effect sizes for face-to-face treatments. However, further research is needed to optimize the use of self-help methods.


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