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Depression: HELP
Articles from Scotland
Based on 701 articles published since 2008
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These are the 701 published articles about Depression that originated from Scotland during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Editorial Depression Phenotype, Inflammation, and the Brain: Implications for Future Research. 2016

Krishnadas, Rajeev / Harrison, Neil A. ·From the Institute of Neuroscience and Psychology (Krishnadas), University of Glasgow, Glasgow, United Kingdom · and Department of Neuroscience, Clinical Imaging Sciences Centre (Harrison), Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom. ·Psychosom Med · Pubmed #27128110.

ABSTRACT: Inflammation is implicated in the etiology of major depressive disorder (MDD). Human neuroimaging techniques are increasingly used to characterize the neural circuitry mediating actions of inflammation on mood, motivation, and cognition and its relationship to MDD. In this issue of Psychosomatic Medicine, Byrne and colleagues report the first systematic review of these studies. The systematic review provides a much-needed synthesis of current research findings and highlights the role of cortical and subcortical brain structure and function. In this accompanying commentary, we highlight further points of particular relevance to future studies, including the potential advantages of functional phenotype models rather than the emphasis on mutually exclusive diagnostic categories in describing MDD and other psychiatric disorders. Novel imaging techniques will further enhance possibilities to clarify the link between inflammation and depression. New research challenges are described regarding the relationships between behavioral phenotype, brain structure and function, and peripheral inflammation.

2 Editorial Comorbidity of depression and anxiety disorders in patients with hypertension. 2016

Graham, Nicholas / Smith, Daniel J. ·Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK. ·J Hypertens · Pubmed #26818922.

ABSTRACT: -- No abstract --

3 Editorial Reliever Inhaler Overuse, Asthma Symptoms, and Depression. 2015

Thomson, Neil C. ·Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, United Kingdom. Electronic address: neil.thomson@glasgow.ac.uk. ·J Allergy Clin Immunol Pract · Pubmed #26553619.

ABSTRACT: -- No abstract --

4 Editorial Risk of intracranial haemorrhage linked to co-treatment with antidepressants and NSAIDs. 2015

Mercer, Stewart W / Payne, Rupert A / Nicholl, Barbara I / Morrison, Jill. ·General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, UK stewart.mercer@glasgow.ac.uk. · Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge CB2 0SR, UK. · General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, UK. ·BMJ · Pubmed #26173949.

ABSTRACT: -- No abstract --

5 Editorial Poststroke depression and 5-HTTLPR. 2014

Queirazza, Filippo / Cavanagh, Jonathan. ·IHW, University of Glasgow, Southern General Hospital, Glasgow, UK. ·J Neurol Neurosurg Psychiatry · Pubmed #23715919.

ABSTRACT: -- No abstract --

6 Editorial Towards clinically useful neuroimaging in psychiatric practice. 2013

Cooper, Deborah / Limet, Natalie / McClung, Ian / Lawrie, Stephen M. ·Deborah Cooper, MB ChB, MRCPsych, General Adult Psychiatry; Natalie Limet, MB ChB, MRCPsych, Ian McClung, MB ChB, MRCPsych, Old Age Psychiatry; Stephen M. Lawrie, MD(Hons), FRCPsych, University Division of Psychiatry, Royal Edinburgh Hospital, UK. ·Br J Psychiatry · Pubmed #24085734.

ABSTRACT: When psychiatrists see a patient, they consider a diagnosis, estimate a prognosis and treat accordingly, but very few of these decisions are informed by objective tests. Recent advances in neuroimaging data analysis have shown that brain scans can make powerful diagnostic and prognostic predictions in patients with psychosis and depression.

7 Review Family and Support Networks Following Critical Illness. 2018

Haines, Kimberley J / Quasim, Tara / McPeake, Joanne. ·Department of Physiotherapy, Western Health, Sunshine Hospital, 176 Furlong Road, St Albans, Melbourne, Victoria 3021, Australia; Australian and New Zealand Intensive Care Research Centre, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia. Electronic address: Kimberley.haines@wh.org.au. · Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, 84 Castle Street, Glasgow G4 0SF, Scotland; School of Medicine, Dentistry and Nursing, University of Glasgow, University Avenue, Glasgow G12 8QQ, Scotland. ·Crit Care Clin · Pubmed #30223998.

ABSTRACT: Research highlights the psychosocial impact of critical illness on family who typically adopt a caregiver role to the survivor. We review evidence on informal caregiver psychosocial outcomes and interventional studies designed to improve them. We argue informal caregivers have distinct and complex needs that differ from patients. Interventional studies ought to be designed for this cohort with careful attention paid to the timing of interventions. We consider the influence of social isolation on recovery and discuss service improvement approaches to build social support networks to enhance recovery, where caregivers and survivors are involved in the design of aftercare programs.

8 Review Walking on sunshine: scoping review of the evidence for walking and mental health. 2018

Kelly, Paul / Williamson, Chloë / Niven, Ailsa G / Hunter, Ruth / Mutrie, Nanette / Richards, Justin. ·Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK. · Queen's University Belfast, Belfast, UK. · Charles Perkins Centre & School of Public Health, University of Sydney, Sydney, New South Wales, Australia. ·Br J Sports Med · Pubmed #29858467.

ABSTRACT: BACKGROUND/OBJECTIVES: Walking has well-established positive relationships with, and effects on, physical health. In contrast, while poor mental health contributes substantially to global health burden, an overview of the benefits from walking has not previously been published. We aimed to scope the literature and present what is known, and highlight what is not known, about walking and mental health. METHODS: Design: Scoping review. DATA SOURCES: Ovid (Medline), ProQuest, Web of Science.Screening and reporting: 13 014 records were identified and screened by a team of researchers. Included full texts were analysed and reported according to mental health outcome. RESULTS: For the 8 mental health outcomes (identified a priori), there were a total of 5 systematic reviews and 50 individual papers included. Depression had the most evidence and existing systematic reviews were reported. Evidence for anxiety, psychological stress, psychological well-being, subjective well-being and social isolation and loneliness varied in volume and effectiveness, but no harmful effects were identified. There were no studies for walking and resilience. The setting and context of walking seems to be important variables. CONCLUSION: The evidence base that suggests walking benefits mental health is growing, but remains fragmented and incomplete for some important outcomes. Policy and national guidelines should promote the known mental health benefits of increased walking and future research should directly address the gaps we have identified.

9 Review Common variants on 6q16.2, 12q24.31 and 16p13.3 are associated with major depressive disorder. 2018

Li, Xiaoyan / Luo, Zhenwu / Gu, Chunjie / Hall, Lynsey S / McIntosh, Andrew M / Zeng, Yanni / Porteous, David J / Hayward, Caroline / Li, Ming / Yao, Yong-Gang / Zhang, Chen / Luo, Xiong-Jian / Anonymous8181104. ·Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China. · Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, Yunnan, China. · Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, 29425, USA. · Division of Psychiatry, University of Edinburgh, Edinburgh, UK. · MRC Human Genetic Unit, IGMM, University of Edinburgh, Edinburgh, UK. · Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, EH4 2XU, UK. · CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China. · Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. zhangchen645@163.com. · Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China. luoxiongjian@mail.kiz.ac.cn. · Center for Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming, 650223, China. luoxiongjian@mail.kiz.ac.cn. ·Neuropsychopharmacology · Pubmed #29728651.

ABSTRACT: Accumulating evidence suggests that genetic factors have a role in major depressive disorder (MDD). However, only limited MDD risk loci have been identified so far. Here we perform a meta-analysis (a total of 90,150 MDD cases and 246,603 controls) through combing three genome-wide association studies of MDD, including 23andMe (cases were self-reported with a clinical diagnosis or treatment of depression), CONVERGE (cases were diagnosed using the Composite International Diagnostic Interview) and PGC (cases were diagnosed using direct structured diagnostic interview (by trained interviewers) or clinician-administered DSM-IV checklists). Genetic variants from two previously unreported loci (rs10457592 on 6q16.2 and rs2004910 on 12q24.31) showed significant associations with MDD (P < 5 × 10

10 Review Psychological therapy for inpatients receiving acute mental health care: A systematic review and meta-analysis of controlled trials. 2018

Paterson, Charlotte / Karatzias, Thanos / Dickson, Adele / Harper, Sean / Dougall, Nadine / Hutton, Paul. ·School of Health and Social Care, Edinburgh Napier University, UK. · Rivers Centre for Traumatic Stress, Fountainbridge Library, NHS Lothian, Edinburgh, UK. · Department of Psychology and Allied Health Sciences, Glasgow Caledonian University, UK. ·Br J Clin Psychol · Pubmed #29660770.

ABSTRACT: OBJECTIVES: The effectiveness of psychological therapies for those receiving acute adult mental health inpatient care remains unclear, partly because of the difficulty in conducting randomized controlled trials (RCTs) in this setting. The aim of this meta-analysis was to synthesize evidence from all controlled trials of psychological therapy carried out with this group, to estimate its effects on a number of important outcomes and examine whether the presence of randomization and rater blinding moderated these estimates. METHOD: A systematic review and meta-analysis of all controlled trials of psychological therapy delivered in acute inpatient settings was conducted, with a focus on psychotic symptoms, readmissions or emotional distress (anxiety and depression). Studies were identified through ASSIA, EMBASE, CINAHL, Cochrane, MEDLINE, and PsycINFO using a combination of the key terms 'inpatient', 'psychological therapy', and 'acute'. No restriction was placed on diagnosis. The moderating effect of the use of assessor-blind RCT methodology was examined via subgroup and sensitivity analyses. RESULTS: Overall, psychological therapy was associated with small-to-moderate improvements in psychotic symptoms at end of therapy but the effect was smaller and not significant at follow-up. Psychological therapy was also associated with reduced readmissions, depression, and anxiety. The use of single-blind randomized controlled trial methodology was associated with significantly reduced benefits on psychotic symptoms and was also associated with reduced benefits on readmission and depression; however, these reductions were not statistically significant. CONCLUSIONS: The provision of psychological therapy to acute psychiatric inpatients is associated with improvements; however, the use of single-blind RCT methodology was associated with reduced therapy-attributable improvements. Whether this is a consequence of increased internal validity or reduced external validity is unclear. Trials with both high internal and external validity are now required to establish what type, format, and intensity of brief psychological therapy is required to achieve sustained benefits. PRACTITIONER POINTS: Clinical implications: This review provides the first meta-analytical synthesis of brief psychological therapy delivered in acute psychiatric inpatient settings. This review suggests that brief psychological therapy may be associated with reduced emotional distress and readmissions. LIMITATIONS: The evidence in this review is of limited quality. The type, format, and intensity of brief psychological therapy required to achieve sustained benefits are yet to be established.

11 Review The use of polygenic risk scores to identify phenotypes associated with genetic risk of bipolar disorder and depression: A systematic review. 2018

Mistry, Sumit / Harrison, Judith R / Smith, Daniel J / Escott-Price, Valentina / Zammit, Stanley. ·Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK. Electronic address: mistrys1@cardiff.ac.uk. · Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK. · Institute of Health and Wellbeing, University of Glasgow, I Lilybank Gardens, UK. · Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK; Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK. ·J Affect Disord · Pubmed #29529547.

ABSTRACT: BACKGROUND: Identifying the phenotypic manifestations of increased genetic liability for depression (MDD) and bipolar disorder (BD) can enhance understanding of their aetiology. The polygenic risk score (PRS) derived using data from genome-wide-association-studies can be used to explore how genetic risk is manifest in different samples. AIMS: In this systematic review, we review studies that examine associations between the MDD and BD polygenic risk scores and phenotypic outcomes. METHODS: Following PRISMA guidelines, we searched EMBASE, Medline and PsycINFO (from August 2009 - 14th March 2016) and references of included studies. Study inclusion was based on predetermined criteria and data were extracted independently and in duplicate. RESULTS: Twenty-five studies were included. Overall, both polygenic risk scores were associated with other psychiatric disorders (not the discovery sample disorder) such as depression, schizophrenia and bipolar disorder, greater symptom severity of depression, membership of a creative profession and greater educational attainment. Both depression and bipolar polygenic risk scores explained small amounts of variance in most phenotypes (< 2%). LIMITATIONS: Many studies did not report standardised effect sizes. This prevented us from conducting a meta-analysis. CONCLUSIONS: Polygenic risk scores for BD and MDD are associated with a range of phenotypes and outcomes. However, they only explain a small amount of the variation in these phenotypes. Larger discovery and adequately powered target samples are required to increase power of the PRS approach. This could elucidate how genetic risk for bipolar disorder and depression is manifest and contribute meaningfully to stratified medicine.

12 Review Chemokines in depression in health and in inflammatory illness: a systematic review and meta-analysis. 2018

Leighton, S P / Nerurkar, L / Krishnadas, R / Johnman, C / Graham, G J / Cavanagh, J. ·Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK. · Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK. · Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK. · Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK. ·Mol Psychiatry · Pubmed #29133955.

ABSTRACT: Inflammatory illness is associated with depression. Preclinical work has shown that chemokines are linked with peripheral-central crosstalk and may be important in mediating depressive behaviours. We sought to establish what evidence exists that differences in blood or cerebrospinal fluid chemokine concentration discriminate between individuals with depression and those without. Following PRISMA guidelines, we systematically searched Embase, PsycINFO and Medline databases. We included participants with physical illness for subgroup analysis, and excluded participants with comorbid psychiatric diagnoses. Seventy-three studies met the inclusion criteria for the meta-analysis. Individuals with depression had higher levels of blood CXCL4 and CXCL7 and lower levels of blood CCL4. Sensitivity analysis of studies with only physically healthy participants identified higher blood levels of CCL2, CCL3, CCL11, CXCL7 and CXCL8 and lower blood levels of CCL4. All other chemokines examined did not reveal significant differences (blood CCL5, CCL7, CXCL9, CXCL10 and cerebrospinal fluid CXCL8 and CXCL10). Analysis of the clinical utility of the effect size of plasma CXCL8 in healthy individuals found a negative predictive value 93.5%, given the population prevalence of depression of 10%. Overall, our meta-analysis finds evidence linking abnormalities of blood chemokines with depression in humans. Furthermore, we have demonstrated the possibility of classifying individuals with depression based on their inflammatory biomarker profile. Future research should explore putative mechanisms underlying this association, attempt to replicate existing findings in larger populations and aim to develop new diagnostic and therapeutic strategies.

13 Review A neuro-immune, neuro-oxidative and neuro-nitrosative model of prenatal and postpartum depression. 2018

Roomruangwong, Chutima / Anderson, George / Berk, Michael / Stoyanov, Drozdstoy / Carvalho, André F / Maes, Michael. ·Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. · CRC, Scotland and London, UK. · Impact Strategic Research Center, Deakin University, Geelong, Australia; Orygen, the National Centre of Excellence in Youth Mental Health and Orygen Research, Australia. · Medical University of Plovdiv, Department of Psychiatry and Medical Psychology, Technology Center for Emergency Medicine, Bulgaria. · Department of Clinical Medicine, Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil. · Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Impact Strategic Research Center, Deakin University, Geelong, Australia; Medical University of Plovdiv, Department of Psychiatry and Medical Psychology, Technology Center for Emergency Medicine, Bulgaria. Electronic address: dr.michaelmaes@hotmail.com. ·Prog Neuropsychopharmacol Biol Psychiatry · Pubmed #28941769.

ABSTRACT: A large body of evidence indicates that major affective disorders are accompanied by activated neuro-immune, neuro-oxidative and neuro-nitrosative stress (IO&NS) pathways. Postpartum depression is predicted by end of term prenatal depressive symptoms whilst a lifetime history of mood disorders appears to increase the risk for both prenatal and postpartum depression. This review provides a critical appraisal of available evidence linking IO&NS pathways to prenatal and postpartum depression. The electronic databases Google Scholar, PubMed and Scopus were sources for this narrative review focusing on keywords, including perinatal depression, (auto)immune, inflammation, oxidative, nitric oxide, nitrosative, tryptophan catabolites (TRYCATs), kynurenine, leaky gut and microbiome. Prenatal depressive symptoms are associated with exaggerated pregnancy-specific changes in IO&NS pathways, including increased C-reactive protein, advanced oxidation protein products and nitric oxide metabolites, lowered antioxidant levels, such as zinc, as well as lowered regulatory IgM-mediated autoimmune responses. The latter pathways coupled with lowered levels of endogenous anti-inflammatory compounds, including ω3 polyunsaturated fatty acids, may also underpin the pathophysiology of postpartum depression. Although increased bacterial translocation, lipid peroxidation and TRYCAT pathway activation play a role in mood disorders, similar changes do not appear to be relevant in perinatal depression. Some IO&NS biomarker characteristics of mood disorders are found in prenatal depression indicating that these pathways partly contribute to the association of a lifetime history of mood disorders and perinatal depression. However, available evidence suggests that some IO&NS pathways differ significantly between perinatal depression and mood disorders in general. This review provides a new IO&NS model of prenatal and postpartum depression.

14 Review Linking the biological underpinnings of depression: Role of mitochondria interactions with melatonin, inflammation, sirtuins, tryptophan catabolites, DNA repair and oxidative and nitrosative stress, with consequences for classification and cognition. 2018

Anderson, George. ·CRC Scotland & London, Eccleston Square, London, UK. Electronic address: anderson.george@rocketmail.com. ·Prog Neuropsychopharmacol Biol Psychiatry · Pubmed #28433458.

ABSTRACT: The pathophysiological underpinnings of neuroprogressive processes in recurrent major depressive disorder (rMDD) are reviewed. A wide array of biochemical processes underlie MDD presentations and their shift to a recurrent, neuroprogressive course, including: increased immune-inflammation, tryptophan catabolites (TRYCATs), mitochondrial dysfunction, aryl hydrocarbonn receptor activation, and oxidative and nitrosative stress (O&NS), as well as decreased sirtuins and melatonergic pathway activity. These biochemical changes may have their roots in central, systemic and/or peripheral sites, including in the gut, as well as in developmental processes, such as prenatal stressors and breastfeeding consequences. Consequently, conceptualizations of MDD have dramatically moved from simple psychological and central biochemical models, such as lowered brain serotonin, to a conceptualization that incorporates whole body processes over a lifespan developmental timescale. However, important hubs are proposed, including the gut-brain axis, and mitochondrial functioning, which may provide achievable common treatment targets despite considerable inter-individual variability in biochemical changes. This provides a more realistic model of the complexity of MDD and the pathophysiological processes that underpin the shift to rMDD and consequent cognitive deficits. Such accumulating data on the pathophysiological processes underpinning MDD highlights the need in psychiatry to shift to a classification system that is based on biochemical processes, rather than subjective phenomenology.

15 Review Yoga for stroke rehabilitation. 2017

Lawrence, Maggie / Celestino Junior, Francisco T / Matozinho, Hemilianna Hs / Govan, Lindsay / Booth, Jo / Beecher, Jane. ·Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, A101f, Govan Mbeki Building, Glasgow, UK, G4 0BA. ·Cochrane Database Syst Rev · Pubmed #29220541.

ABSTRACT: BACKGROUND: Stroke is a major health issue and cause of long-term disability and has a major emotional and socioeconomic impact. There is a need to explore options for long-term sustainable interventions that support stroke survivors to engage in meaningful activities to address life challenges after stroke. Rehabilitation focuses on recovery of function and cognition to the maximum level achievable, and may include a wide range of complementary strategies including yoga.Yoga is a mind-body practice that originated in India, and which has become increasingly widespread in the Western world. Recent evidence highlights the positive effects of yoga for people with a range of physical and psychological health conditions. A recent non-Cochrane systematic review concluded that yoga can be used as self-administered practice in stroke rehabilitation. OBJECTIVES: To assess the effectiveness of yoga, as a stroke rehabilitation intervention, on recovery of function and quality of life (QoL). SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (last searched July 2017), Cochrane Central Register of Controlled Trials (CENTRAL) (last searched July 2017), MEDLINE (to July 2017), Embase (to July 2017), CINAHL (to July 2017), AMED (to July 2017), PsycINFO (to July 2017), LILACS (to July 2017), SciELO (to July 2017), IndMED (to July 2017), OTseeker (to July 2017) and PEDro (to July 2017). We also searched four trials registers, and one conference abstracts database. We screened reference lists of relevant publications and contacted authors for additional information. SELECTION CRITERIA: We included randomised controlled trials (RCTs) that compared yoga with a waiting-list control or no intervention control in stroke survivors. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data from the included studies. We performed all analyses using Review Manager (RevMan). One review author entered the data into RevMan; another checked the entries. We discussed disagreements with a third review author until consensus was reached. We used the Cochrane 'Risk of bias' tool. Where we considered studies to be sufficiently similar, we conducted a meta-analysis by pooling the appropriate data. For outcomes for which it was inappropriate or impossible to pool quantitatively, we conducted a descriptive analysis and provided a narrative summary. MAIN RESULTS: We included two RCTs involving 72 participants. Sixty-nine participants were included in one meta-analysis (balance). Both trials assessed QoL, along with secondary outcomes measures relating to movement and psychological outcomes; one also measured disability.In one study the Stroke Impact Scale was used to measure QoL across six domains, at baseline and post-intervention. The effect of yoga on five domains (physical, emotion, communication, social participation, stroke recovery) was not significant; however, the effect of yoga on the memory domain was significant (mean difference (MD) 15.30, 95% confidence interval (CI) 1.29 to 29.31, P = 0.03), the evidence for this finding was very low grade. In the second study, QoL was assessed using the Stroke-Specifc QoL Scale; no significant effect was found.Secondary outcomes included movement, strength and endurance, and psychological variables, pain, and disability.Balance was measured in both studies using the Berg Balance Scale; the effect of intervention was not significant (MD 2.38, 95% CI -1.41 to 6.17, P = 0.22). Sensititivy analysis did not alter the direction of effect. One study measured balance self-efficacy, using the Activities-specific Balance Confidence Scale (MD 10.60, 95% CI -7.08,= to 28.28, P = 0.24); the effect of intervention was not significant; the evidence for this finding was very low grade.One study measured gait using the Comfortable Speed Gait Test (MD 1.32, 95% CI -1.35 to 3.99, P = 0.33), and motor function using the Motor Assessment Scale (MD -4.00, 95% CI -12.42 to 4.42, P = 0.35); no significant effect was found based on very low-grade evidence.One study measured disability using the modified Rankin Scale (mRS) but reported only whether participants were independent or dependent. No significant effect was found: (odds ratio (OR) 2.08, 95% CI 0.50 to 8.60, P = 0.31); the evidence for this finding was very low grade.Anxiety and depression were measured in one study. Three measures were used: the Geriatric Depression Scale-Short Form (GCDS15), and two forms of State Trait Anxiety Inventory (STAI, Form Y) to measure state anxiety (i.e. anxiety experienced in response to stressful situations) and trait anxiety (i.e. anxiety associated with chronic psychological disorders). No significant effect was found for depression (GDS15, MD -2.10, 95% CI -4.70 to 0.50, P = 0.11) or for trait anxiety (STAI-Y2, MD -6.70, 95% CI -15.35 to 1.95, P = 0.13), based on very low-grade evidence. However, a significant effect was found for state anxiety: STAI-Y1 (MD -8.40, 95% CI -16.74 to -0.06, P = 0.05); the evidence for this finding was very low grade.No adverse events were reported.Quality of the evidenceWe assessed the quality of the evidence using GRADE. Overall, the quality of the evidence was very low, due to the small number of trials included in the review both of which were judged to be at high risk of bias, particularly in relation to incompleteness of data and selective reporting, and especially regarding the representative nature of the sample in one study. AUTHORS' CONCLUSIONS: Yoga has the potential for being included as part of patient-centred stroke rehabilitation. However, this review has identified insufficient information to confirm or refute the effectiveness or safety of yoga as a stroke rehabilitation treatment. Further large-scale methodologically robust trials are required to establish the effectiveness of yoga as a stroke rehabilitation treatment.

16 Review Occupational therapy for adults with problems in activities of daily living after stroke. 2017

Legg, Lynn A / Lewis, Sharon R / Schofield-Robinson, Oliver J / Drummond, Avril / Langhorne, Peter. ·NHS Greater Glasgow and Clyde Health Board, Royal Alexandra Hospital, Paisley, UK, PA2 9PN. ·Cochrane Database Syst Rev · Pubmed #28721691.

ABSTRACT: BACKGROUND: A stroke occurs when the blood supply to part of the brain is cut off. Activities of daily living (ADL) are daily home-based activities that people carry out to maintain health and well-being. ADLs include the ability to: eat and drink unassisted, move, go to the toilet, carry out personal hygiene tasks, dress unassisted, and groom. Stroke causes impairment-related functional limitations that may result in difficulties participating in ADLs independent of supervision, direction, or physical assistance.For adults with stroke, the goal of occupational therapy is to improve their ability to carry out activities of daily living. Strategies used by occupational therapists include assessment, treatment, adaptive techniques, assistive technology, and environmental adaptations. This is an update of the Cochrane review first published in 2006. OBJECTIVES: To assess the effects of occupational therapy interventions on the functional ability of adults with stroke in the domain of activities of daily living, compared with no intervention or standard care/practice. SEARCH METHODS: For this update, we searched the Cochrane Stroke Group Trials Register (last searched 30 January 2017), the Cochrane Controlled Trials Register (The Cochrane Library, January 2017), MEDLINE (1946 to 5 January 2017), Embase (1974 to 5 January 2017), CINAHL (1937 to January 2017), PsycINFO (1806 to 2 November 2016), AMED (1985 to 1 November 2016), and Web of Science (1900 to 6 January 2017). We also searched grey literature and clinical trials registers. SELECTION CRITERIA: We identified randomised controlled trials of an occupational therapy intervention (compared with no intervention or standard care/practice) where people with stroke practiced activities of daily living, or where performance in activities of daily living was the focus of the occupational therapy intervention. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials, assessed risk of bias, and extracted data for prespecified outcomes. The primary outcomes were the proportion of participants who had deteriorated or were dependent in personal activities of daily living and performance in activities of daily living at the end of follow-up. MAIN RESULTS: We included nine studies with 994 participants in this update. Occupational therapy targeted towards activities of daily living after stroke increased performance scores (standardised mean difference (SMD) 0.17, 95% confidence interval (CI) 0.03 to 0.31, P = 0.02; 7 studies; 749 participants; low-quality evidence) and reduced the risk of poor outcome (death, deterioration or dependency in personal activities of daily living) (odds ratio (OR) 0.71, 95% CI 0.52 to 0.96; P = 0.03; 5 studies; 771 participants; low-quality evidence). We also found that those who received occupational therapy were more independent in extended activities of daily living (OR 0.22 (95% CI 0.07 to 0.37); P = 0.005; 5 studies; 665 participants; low-quality evidence). Occupational therapy did not influence mortality (OR: 1.02 (95% CI 0.65 to 1.61); P = 0.93; 8 studies; 950 participants), or reduce the combined odds of death and institutionalisation (OR 0.89 (95% CI 0.60 to 1.32); P = 0.55; 4 studies; 671 participants), or death and dependency (OR 0.89 (95% CI 0.64 to 1.23); P = 0.47; 4 trials; 659 participants). Occupational therapy did not improve mood or distress scores (OR 0.08 (95% CI -0.09 to 0.26); P = 0.35; 4 studies; 519 participants; low-quality evidence). There were insufficient data to determine the effects of occupational therapy on health-related quality of life. We found no studies of consenting carers prior to study participation and therefore there were no carer-related outcomes in our review. There were insufficient data to determine participants' and carers' satisfaction with services.Using GRADE, the quality of evidence was low. The major limitation was the number of studies at unclear risk of selection bias and an inevitable high risk of performance and detection bias, as both participants and occupational therapists could not be blinded to the intervention. In addition, there was a sparseness of data for our outcomes of interest and we downgraded the quality of our evidence for these reasons. AUTHORS' CONCLUSIONS: We found low-quality evidence that occupational therapy targeted towards activities of daily living after stroke can improve performance in activities of daily living and reduce the risk of deterioration in these abilities. Because the included studies had methodological flaws, this research does not provide a reliable indication of the likely effect of occupational therapy for adults with stroke.

17 Review Interventions for treating anxiety after stroke. 2017

Knapp, Peter / Campbell Burton, C Alexia / Holmes, John / Murray, Jenni / Gillespie, David / Lightbody, C Elizabeth / Watkins, Caroline L / Chun, Ho-Yan Y / Lewis, Sharon R. ·Department of Health Sciences, University of York, York, UK, YO10 5DD. · Adelphi Values, Bollington, Cheshire, UK. · Hospital Mental Health Team for Older People, Leeds and York Partnership NHS Foundation Trust, Basement Office, Beckett Wing, St James University Hospital, Beckett Street, Leeds, UK, LS9 7TF. · Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, Bradford, UK, BD9 6RJ. · Department of Neuropsychology, Astley Ainslie Hospital, 133 Grange Loan, Edinburgh, UK, EH9 2HL. · College of Health and Wellbeing, University of Central Lancashire, Preston, UK, PR1 2HE. · Australian Catholic University, New South Wales, Australia. · Faculty of Health Sciences, Australian Catholic University, Sydney, Australia. · Centre for Clinical Brain Sciences, University of Edinburgh, The Chancellor's Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB. · Patient Safety Research Department, Royal Lancaster Infirmary, Pointer Court 1, Ashton Road, Lancaster, UK, LA1 4RP. ·Cochrane Database Syst Rev · Pubmed #28535332.

ABSTRACT: BACKGROUND: Approximately 20% of stroke patients experience clinically significant levels of anxiety at some point after stroke. Physicians can treat these patients with antidepressants or other anxiety-reducing drugs, or both, or they can provide psychological therapy. This review looks at available evidence for these interventions. This is an update of the review first published in October 2011. OBJECTIVES: The primary objective was to assess the effectiveness of pharmaceutical, psychological, complementary, or alternative therapeutic interventions in treating stroke patients with anxiety disorders or symptoms. The secondary objective was to identify whether any of these interventions for anxiety had an effect on quality of life, disability, depression, social participation, caregiver burden, or risk of death. SEARCH METHODS: We searched the trials register of the Cochrane Stroke Group (January 2017). We also searched the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library; 2017, Issue 1: searched January 2017); MEDLINE (1966 to January 2017) in Ovid; Embase (1980 to January 2017) in Ovid; the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1937 to January 2017) in EBSCO; and PsycINFO (1800 to January 2017) in Ovid. We conducted backward citation searches of reviews identified through database searches and forward citation searches of included studies. We contacted researchers known to be involved in related trials, and we searched clinical trials registers for ongoing studies. SELECTION CRITERIA: We included randomised trials including participants with a diagnosis of both stroke and anxiety for which treatment was intended to reduce anxiety. Two review authors independently screened and selected titles and abstracts for inclusion. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed risk of bias. We performed a narrative review. We planned to do a meta-analysis but were unable to do so as included studies were not sufficiently comparable. MAIN RESULTS: We included three trials (four interventions) involving 196 participants with stroke and co-morbid anxiety. One trial (described as a 'pilot study') randomised 21 community-dwelling stroke survivors to four-week use of a relaxation CD or to wait list control. This trial assessed anxiety using the Hospital Anxiety and Depression Scale and reported a reduction in anxiety at three months among participants who had used the relaxation CD (mean (standard deviation (SD) 6.9 (± 4.9) and 11.0 (± 3.9)), Cohen's d = 0.926, P value = 0.001; 19 participants analysed).The second trial randomised 81 participants with co-morbid anxiety and depression to paroxetine, paroxetine plus psychotherapy, or standard care. Mean levels of anxiety severity scores based on the Hamilton Anxiety Scale (HAM-A) at follow-up were 5.4 (SD ± 1.7), 3.8 (SD ± 1.8), and 12.8 (SD ± 1.9), respectively (P value < 0.01).The third trial randomised 94 stroke patients, also with co-morbid anxiety and depression, to receive buspirone hydrochloride or standard care. At follow-up, the mean levels of anxiety based on the HAM-A were 6.5 (SD ± 3.1) and 12.6 (SD ± 3.4) in the two groups, respectively, which represents a significant difference (P value < 0.01). Half of the participants receiving paroxetine experienced adverse events that included nausea, vomiting, or dizziness; however, only 14% of those receiving buspirone experienced nausea or palpitations. Trial authors provided no information about the duration of symptoms associated with adverse events. The trial of relaxation therapy reported no adverse events.The quality of the evidence was very low. Each study included a small number of participants, particularly the study of relaxation therapy. Studies of pharmacological agents presented details too limited to allow judgement of selection, performance, and detection bias and lack of placebo treatment in control groups. Although the study of relaxation therapy had allocated participants to treatment using an adequate method of randomisation, study recruitment methods might have introduced bias, and drop-outs in the intervention group may have influenced results. AUTHORS' CONCLUSIONS: Evidence is insufficient to guide the treatment of anxiety after stroke. Further well-conducted randomised controlled trials (using placebo or attention controls) are required to assess pharmacological agents and psychological therapies.

18 Review Mindfulness-based stress reduction in Parkinson's disease: a systematic review. 2017

McLean, G / Lawrence, M / Simpson, R / Mercer, S W. ·General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, I Horselethill Road, Glasgow, Scotland, G12 9LX, UK. · Institute for Applied Health Research, School of Health and Life Sciences Glasgow Caledonian University, Glasgow, G4 0BA, UK. · General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, I Horselethill Road, Glasgow, Scotland, G12 9LX, UK. Stewart.Mercer@glasgow.ac.uk. ·BMC Neurol · Pubmed #28506263.

ABSTRACT: BACKGROUND: Mindfulness based stress reduction (MBSR) is increasingly being used to improve outcomes such as stress and depression in a range of long-term conditions (LTCs). While systematic reviews on MBSR have taken place for a number of conditions there remains limited information on its impact on individuals with Parkinson's disease (PD). METHODS: Medline, Central, Embase, Amed, CINAHAL were searched in March 2016. These databases were searched using a combination of MeSH subject headings where available and keywords in the title and abstracts. We also searched the reference lists of related reviews. Study quality was assessed based on questions from the Cochrane Collaboration risk of bias tool. RESULTS: Two interventions and three papers with a total of 66 participants were included. The interventions were undertaken in Belgium (n = 27) and the USA (n = 39). One study reported significantly increased grey matter density (GMD) in the brains of the MBSR group compared to the usual care group. Significant improvements were reported in one study for a number of outcomes including PD outcomes, depression, mindfulness, and quality of life indicators. Only one intervention was of reasonable quality and both interventions failed to control for potential confounders in the analysis. Adverse events and reasons for drop-outs were not reported. There was also no reporting on the costs/benefits of the intervention or how they affected health service utilisation. CONCLUSION: This systematic review found limited and inconclusive evidence of the effectiveness of MBSR for PD patients. Both of the included interventions claimed positive effects for PD patients but significant outcomes were often contradicted by other results. Further trials with larger sample sizes, control groups and longer follow-ups are needed before the evidence for MBSR in PD can be conclusively judged.

19 Review Shared metabolic and immune-inflammatory, oxidative and nitrosative stress pathways in the metabolic syndrome and mood disorders. 2017

de Melo, Luiz Gustavo Piccoli / Nunes, Sandra Odebrecht Vargas / Anderson, George / Vargas, Heber Odebrecht / Barbosa, Décio Sabbattini / Galecki, Piotr / Carvalho, André F / Maes, Michael. ·Department of Clinical Medicine, Londrina State University (UEL), Health Sciences Centre, Londrina, Paraná, Brazil; Center of Approach and Treatment for Smokers, University Hospital, Londrina State University, University Campus, Londrina, Paraná, Brazil; Health Sciences Graduation Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil. · CRC Scotland & London, London, UK. · Health Sciences Graduation Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil; Department of Clinical and Toxicological Analysis, State University of Londrina, Londrina, Paraná, Brazil. · Department of Adult Psychiatry, University of Lodz, Lodz, Poland. · Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil. · Health Sciences Graduation Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil; Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand; Department of Psychiatry, Plovdiv University, Plovdiv, Bulgaria; Revitalis, Waalre, The Netherlands; Impact Strategic Research Center, Deakin University, Geelong, Australia. Electronic address: dr.michaelmaes@hotmail.com. ·Prog Neuropsychopharmacol Biol Psychiatry · Pubmed #28438472.

ABSTRACT: This review examines the shared immune-inflammatory, oxidative and nitrosative stress (IO&NS) and metabolic pathways underpinning metabolic syndrome (MetS), bipolar disorder (BD) and major depressive disorder (MDD). Shared pathways in both MetS and mood disorders are low grade inflammation, including increased levels of pro-inflammatory cytokines and acute phase proteins, increased lipid peroxidation with formation of malondialdehyde and oxidized low density lipoprotein cholesterol (LDL-c), hypernitrosylation, lowered levels of antioxidants, most importantly zinc and paraoxonase (PON1), increased bacterial translocation (leaky gut), increased atherogenic index of plasma and Castelli risk indices; and reduced levels of high-density lipoprotein (HDL-c) cholesterol. Insulin resistance is probably not a major factor associated with mood disorders. Given the high levels of IO&NS and metabolic dysregulation in BD and MDD and the high comorbidity with the atherogenic components of the MetS, mood disorders should be viewed as systemic neuro-IO&NS-metabolic disorders. The IO&NS-metabolic biomarkers may have prognostic value and may contribute to the development of novel treatments targeting neuro-immune, neuro-oxidative and neuro-nitrosative pathways.

20 Review Using Selective Serotonin Reuptake Inhibitors and Serotonin-Norepinephrine Reuptake Inhibitors in Critical Care: A Systematic Review of the Evidence for Benefit or Harm. 2017

Kelly, John M / Rubenfeld, Gordon D / Masson, Neil / Min, Arimie / Adhikari, Neill K J. ·1Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. 2Sunnybrook Health Sciences Centre and Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada. 3Department of Psychiatry, Stobhill Hospital, Glasgow, United Kingdom. 4University of Glasgow, Glasgow, United Kingdom. 5Royal College of Surgeons in Ireland, Dublin, Ireland. 6Department of Critical Care Medicine, Sunnybrook Health Sciences Centre and Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada. ·Crit Care Med · Pubmed #28338497.

ABSTRACT: OBJECTIVE: Selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitors are among the most commonly prescribed drugs in patients admitted to the ICU. Our objective was to systematically review available literature for evidence of benefit or harm in ICU patients resulting from chronic effects, continued use, or withdrawal. DATA SOURCES: Medline, Embase, and Cochrane Central Register of Controlled Trials (1990 to November 2014). STUDY SELECTION: We searched for studies of ICU patients with recorded selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor prescription before or during admission, and reporting morbidity, mortality, adverse events, and resource measures like ICU length of stay. We considered all study designs. We excluded studies of deliberate overdose and depression in non-ICU settings. Two authors independently and in duplicate screened citations and reviewed text of studies to apply selection criteria. DATA EXTRACTION: Two authors abstracted data on patient characteristics in exposed and control groups; use of selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitors previously or during ICU; comparator intervention; and outcomes, and also assessed methodologic quality. DATA SYNTHESIS: The database search retrieved 4,172 unique citations, of which 289 were reviewed, and 13 studies representing a total of 20,048 patients met selection criteria. There were five cohort studies, one case series, and seven case reports. Only one case report suggested benefit from selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor use and 11 studies reported morbidity in patients using these medications at admission to ICU. However, due to inadequate drug administration reporting, it was generally unclear if outpatient selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitors were continued in ICU, complicating interpretation. CONCLUSIONS: There may be excess morbidity in critically ill selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor users, but uncertainty remains whether this is due to chronic effects, ongoing use, or drug withdrawal. Further research with improved standards of drug administration reporting is needed to help clinicians decide when to use selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitors in critically ill patients.

21 Review Mindfulness-based interventions in epilepsy: a systematic review. 2017

Wood, Karen / Lawrence, Maggie / Jani, Bhautesh / Simpson, Robert / Mercer, Stewart W. ·General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, 1 Horselethill Road, Glasgow, G12 9LX, Scotland, UK. · Institute for Applied Health Research, School of Health and Life Sciences Glasgow Caledonian University, Glasgow, G4 0BA, Scotland, UK. · General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, 1 Horselethill Road, Glasgow, G12 9LX, Scotland, UK. Stewart.Mercer@glasgow.ac.uk. ·BMC Neurol · Pubmed #28320349.

ABSTRACT: BACKGROUND: Mindfulness based interventions (MBIs) are increasingly used to help patients cope with physical and mental long-term conditions (LTCs). Epilepsy is associated with a range of mental and physical comorbidities that have a detrimental effect on quality of life (QOL), but it is not clear whether MBIs can help. We systematically reviewed the literature to determine the effectiveness of MBIs in people with epilepsy. METHODS: Medline, Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, Allied and Complimentary Medicine Database, and PsychInfo were searched in March 2016. These databases were searched using a combination of subject headings where available and keywords in the title and abstracts. We also searched the reference lists of related reviews. Study quality was assessed using the Cochrane Collaboration risk of bias tool. RESULTS: Three randomised controlled trials (RCTs) with a total of 231 participants were included. The interventions were tested in the USA (n = 171) and China (Hong Kong) (n = 60). Significant improvements were reported in depression symptoms, quality of life, anxiety, and depression knowledge and skills. Two of the included studies were assessed as being at unclear/high risk of bias - with randomisation and allocation procedures, as well as adverse events and reasons for drop-outs poorly reported. There was no reporting on intervention costs/benefits or how they affected health service utilisation. CONCLUSION: This systematic review found limited evidence for the effectiveness of MBIs in epilepsy, however preliminary evidence suggests it may lead to some improvement in anxiety, depression and quality of life. Further trials with larger sample sizes, active control groups and longer follow-ups are needed before the evidence for MBIs in epilepsy can be conclusively determined.

22 Review Online support groups for women with breast cancer. 2017

McCaughan, Eilis / Parahoo, Kader / Hueter, Irene / Northouse, Laurel / Bradbury, Ian. ·Institute of Nursing and Health Research, Ulster University, Coleraine, UK, BT52 1SA. · Statistics Department, Columbia University, 1255 Amsterdam Avenue, New York, NY, USA, 10027. · School of Nursing, University of Michigan, 400 N.Ingalls, Ann Arbor, Michigan, USA, 48105. · Frontier Science Scotland, Kincraig, Scotland, UK. ·Cochrane Database Syst Rev · Pubmed #28278559.

ABSTRACT: BACKGROUND: Survival rates for women with a diagnosis of breast cancer continue to improve. However, some women may experience physical, psychological and emotional effects post diagnosis, throughout treatment and beyond. Support groups can provide opportunities for people to share their experiences and learn from others. As the number of online support groups increases, more and more women with breast cancer will likely access them. OBJECTIVES: To assess effects of online support groups on the emotional distress, uncertainty, anxiety, depression and quality of life (QoL) of women with breast cancer. SEARCH METHODS: We searched for trials in the Cochrane Breast Cancer Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 4), MEDLINE, Embase and PsycINFO on 2 May 2016, and we handsearched journals and reference lists. We also searched the World Health Organization's International Clinical Trials Registry Platform (WHO ICTRP) search portal and clinicaltrials.gov on 2 May 2016. SELECTION CRITERIA: We included randomised controlled trials (RCTs) assessing effects of online support groups on women with a diagnosis of breast cancer and women who have completed breast cancer treatment. We included studies comparing online support groups with a usual care group, and studies comparing two or more types of online support groups (without a usual care group). DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed risk of bias. We presented outcome data using mean differences (MDs) and standardised mean differences (SMDs) along with 95% confidence intervals (CIs), and we used the fixed-effect model when appropriate. We assessed the quality of the body of evidence using the GRADE approach. MAIN RESULTS: We included six studies (492 women) that assessed online support groups for women with breast cancer. Online support groups in these six trials lasted from six to 30 weeks. Women participated in these groups between 1.5 and 2.5 hours per week, and investigators conducted all studies in the USA. Participants were predominantly white and well educated and were moderate to high earners. Four studies compared an online support group versus a control group, and the other two compared a 'moderated' versus a 'peer-led' online support group, and a 'standard' versus an 'enhanced' online support group, respectively.None of the included studies measured 'emotional distress' or uncertainty. One study (78 women) for which data for analysis were missing reported no positive effects of online support on 'distress' and 'cancer-specific distress' versus support provided by a control group. Two studies measured anxiety: One study (72 women) found no difference in anxiety at the end of the intervention between the online support group and the control group (MD -0.40, 95% CI -6.42 to 5.62; low-quality evidence), and the second study (184 women) reported a reduction in anxiety levels at the end of the intervention when comparing the 'standard' support group (run by participants without prompting from health professionals) versus an 'enhanced' online support group (in which participants were specifically asked by the researcher to respond to one another's need for support).Five studies (414 women) measured depression. Three studies compared depression in the online support group with depression in the control group. Pooled data from two studies (120 women) showed a small to moderate reduction in depression in the online support group compared with control groups at the end of the intervention (SMD -0.37, 95% CI -0.75 to 0.00; very low-quality evidence). The third study, a pilot study (30 women), provided no data for analysis but reported no difference in depression between participants in support and control groups at the end of the intervention. Of the remaining two studies that measured depression, one study (60 women) provided no extractable data for comparison but reported no difference in depressive symptoms between a 'moderated' and a 'peer-led' support group; the other study (184 women) reported greater reduction in depression in the 'standard' support group than in the 'enhanced' online support group.Three studies measured quality of life. One pilot study (30 women) provided limited data for analysis but reported no change in quality of life at the end of the intervention. Only two studies (140 women) provided data for pooling and showed no positive effects on quality of life at four months post intervention compared with controls (SMD -0.11, 95% CI -0.47 to 0.24; very low-quality evidence). At 12 months post intervention, one study (78 women) reported that the intervention group did not attain better quality of life scores than the control group (MD -10.89, 95% CI -20.41 to -1.37; low-quality evidence).We found no data for subgroup analyses on stage of disease, treatment modality and types and doses of interventions. No studies measured adverse effects. AUTHORS' CONCLUSIONS: This review did not find the evidence required to show whether participation in online support groups was beneficial for women with breast cancer, because identified trials were small and of low or very low quality. Large, rigorous trials with ethnically and economically diverse participants are needed to provide robust evidence regarding the psychosocial outcomes selected for this review.

23 Review Psychiatric symptomatology after delirium: a systematic review. 2017

Langan, Clare / Sarode, Deep P / Russ, Tom C / Shenkin, Susan D / Carson, Alan / Maclullich, Alasdair M J. ·College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK. · Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK. · Edinburgh Delirium Research Group, Geriatric Medicine, University of Edinburgh, Edinburgh, UK. · Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK. · Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK. ·Psychogeriatrics · Pubmed #28127828.

ABSTRACT: Delirium is an acute and usually transient severe neuropsychiatric syndrome associated with significant long-term physical morbidity. However, its chronic psychiatric sequelae remain poorly characterized. To investigate the prevalence of psychiatric symptoms, namely anxiety, depressive, and post-traumatic stress disorder (PTSD) symptoms after delirium, a systematic literature search of MEDLINE, EMBASE and PsycINFO databases was performed independently by two authors in March 2016. Bibliographies were hand-searched, and a forward- and backward-citation search using Web of Science was performed for all included studies. Of 6411 titles, we included eight prospective cohort studies, including 370 patients with delirium and 1073 without delirium. Studies were heterogeneous and mostly included older people from a range of clinical groups. Consideration of confounders was variable. The prevalence of depressive symptoms was almost three times higher in patients with delirium than in patients without delirium (22.2% vs 8.0%, risk ratio = 2.79; 95% confidence interval = 1.36-5.73). There was no statistically significant difference between the prevalence of anxiety symptoms between patients with and without delirium. The prevalence of PTSD symptoms after delirium was inconclusive: only one study investigated this and no association between PTSD symptoms after delirium was reported. There is limited published evidence of the prevalence of psychiatric symptoms after non-ICU delirium and the strongest evidence is for depressive symptoms. Further longitudinal studies are warranted to investigate the prevalence of anxiety and PTSD symptoms.

24 Review Children and young people's conceptualizations of depression: a systematic review and narrative meta-synthesis. 2017

Georgakakou-Koutsonikou, N / Williams, J M. ·Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK. ·Child Care Health Dev · Pubmed #28090667.

ABSTRACT: BACKGROUND: There is an increasing research interest in conceptualizations of mental illness, examined in association with help-seeking, stigma and treatment preferences. A recent focus on young people's concepts has been identified, with depression being one of the most examined conditions. METHODS: The purpose of this systematic review is to synthesize evidence on children and adolescents' conceptualizations of depression, adopting the model of illness representations. The review further aims to examine developmental trends, gender differences and the role of experience. A systematic review and narrative meta-synthesis were conducted, reviewing 36 studies identified through a systematic search of six databases in March 2016. RESULTS: Thirty-six quantitative and qualitative studies were included. Half of the young people are able to recognize depression, and recognition increases when symptoms are more severe (e.g. suicidality). Young people are able to name a variety of causes for depression. Mental health professionals are considered the appropriate source of help by half of the young people, followed by family and peers. However, stigma constitutes a major barrier to help-seeking. There are developmental trends and gender differences in young people's conceptualization of depression, while experience with depression is associated with a broader conceptualization. CONCLUSIONS: Young people's concepts of depression resemble aspects of adult conceptualizations, however are sometimes incomplete. Further research on younger children and clinical populations is needed. Research on young people's conceptualizations informs both clinical practice and mental health literacy interventions.

25 Review The determinants of food choice. 2017

Leng, Gareth / Adan, Roger A H / Belot, Michele / Brunstrom, Jeffrey M / de Graaf, Kees / Dickson, Suzanne L / Hare, Todd / Maier, Silvia / Menzies, John / Preissl, Hubert / Reisch, Lucia A / Rogers, Peter J / Smeets, Paul A M. ·Centre for Integrative Physiology, University of Edinburgh,George Square,Edinburgh,EH8 9XD,UK. · Department Translational Neuroscience,Brain Center Rudolf Magnus, University Medical Center Utrecht,Utrecht,The Netherlands. · European University Institute,Via dei Roccettini 9,I-50014 San Domenico di Fiesole,Italy. · Nutrition and Behaviour Unit, School of Experimental Psychology, University of Bristol,12a Priory Road,Bristol BS8 1TU,UK. · Division of Human Nutrition,Wageningen University & Research Centre,Wageningen,Stippeneng 4,6708 WE,The Netherlands. · Department Physiology/Endocrine,Institute of Neuroscience and Physiology, The Sahlgrenka Academy at the University of Gothenburg,SE-405 30 Gothenburg,Sweden. · Laboratory for Social and Neural Systems Research, Department of Economics,University of Zurich,Bluemlisalpstrasse 10,8006 Zurich,Switzerland. · Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen; German Center for Diabetes Research (DZD e.V.),Tübingen,Germany. · Department of Intercultural Communication and Management,Copenhagen Business School,Porcelaenshaven 18a,DK - 2000 Frederiksberg,Denmark. ·Proc Nutr Soc · Pubmed #27903310.

ABSTRACT: Health nudge interventions to steer people into healthier lifestyles are increasingly applied by governments worldwide, and it is natural to look to such approaches to improve health by altering what people choose to eat. However, to produce policy recommendations that are likely to be effective, we need to be able to make valid predictions about the consequences of proposed interventions, and for this, we need a better understanding of the determinants of food choice. These determinants include dietary components (e.g. highly palatable foods and alcohol), but also diverse cultural and social pressures, cognitive-affective factors (perceived stress, health attitude, anxiety and depression), and familial, genetic and epigenetic influences on personality characteristics. In addition, our choices are influenced by an array of physiological mechanisms, including signals to the brain from the gastrointestinal tract and adipose tissue, which affect not only our hunger and satiety but also our motivation to eat particular nutrients, and the reward we experience from eating. Thus, to develop the evidence base necessary for effective policies, we need to build bridges across different levels of knowledge and understanding. This requires experimental models that can fill in the gaps in our understanding that are needed to inform policy, translational models that connect mechanistic understanding from laboratory studies to the real life human condition, and formal models that encapsulate scientific knowledge from diverse disciplines, and which embed understanding in a way that enables policy-relevant predictions to be made. Here we review recent developments in these areas.

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