Systematic reviews including this primary study

loading
24 articles (24 References) Revert Studify

Systematic review

Unclassified

Systematic meta-analysis of the risk factors for deliberate self-harm before and after treatment for first-episode psychosis.

Journal Acta psychiatrica Scandinavica
Year 2013
Links Pubmed DOI

Without references

This article is included in 1 Broad synthesis 0 Broad syntheses (1 reference)

Loading references information
OBJECTIVE: Attempted suicide and deliberate self-injury can occur before or after presentation with a first-episode of psychosis. The aim of the study is to identify the factors associated with suicide attempts or deliberate self-injury before and after treatment for first-episode psychosis. METHOD: A systematic review and meta-analysis of controlled studies of factors associated with either suicide attempts or deliberate self-injury, referred to here as deliberate self-harm (DSH). RESULTS: The pooled proportion of patients who reported DSH prior to treatment for first-episode psychosis was 18.4% (95% Confidence Interval (CI) 14.4-23.3, N = 18 studies, I(2) = 93.8). The pooled proportion of patients with DSH during the period of untreated psychosis was 9.8%, (95% CI 6.7-14.2, N = 5 studies, I(2) = 58.9). The pooled proportion of patients committing DSH during periods of follow up of between 1 and 7 years was 11.4%, (95% CI, 8.3-15.5, N = 13 studies, I(2) = 89.2). Categorical factors associated with an increased risk of DSH were a prior history of DSH (OR = 3.94), expressed suicide ideation (OR = 2.34), greater insight (OR = 1.64), alcohol abuse (OR = 1.68) and substance use (OR = 1.46). Continuous variables associated with an increased risk of DSH were younger age of onset (Standardized Mean Difference (SMD) = -0.28), younger age at first treatment (SMD = -0.18), depressed mood (SMD = 0.49) and the duration of untreated psychosis (SMD = 0.20). Depressed mood and substance use were associated with DSH both before and after treatment, negative symptoms were associated with DSH after treatment but not before treatment. Positive symptoms and social and global functioning were not associated with DSH. Younger age and the duration of untreated psychosis were associated with DSH before treatment but not after treatment. CONCLUSION: Earlier treatment of first-episode psychosis and successful treatment of depression and substance use could prevent some episodes of DSH and might reduce suicide mortality in early psychosis.

Systematic review

Unclassified

Risk factors for violence in psychosis: systematic review and meta-regression analysis of 110 studies.

Authors Witt K , van Dorn R , Fazel S
Journal PloS one
Year 2013
Links Pubmed DOI PubMed Central

Without references

This article is included in 1 Broad synthesis 0 Broad syntheses (1 reference)

Loading references information
BACKGROUND: Previous reviews on risk and protective factors for violence in psychosis have produced contrasting findings. There is therefore a need to clarify the direction and strength of association of risk and protective factors for violent outcomes in individuals with psychosis. METHOD: We conducted a systematic review and meta-analysis using 6 electronic databases (CINAHL, EBSCO, EMBASE, Global Health, PsycINFO, PUBMED) and Google Scholar. Studies were identified that reported factors associated with violence in adults diagnosed, using DSM or ICD criteria, with schizophrenia and other psychoses. We considered non-English language studies and dissertations. Risk and protective factors were meta-analysed if reported in three or more primary studies. Meta-regression examined sources of heterogeneity. A novel meta-epidemiological approach was used to group similar risk factors into one of 10 domains. Sub-group analyses were then used to investigate whether risk domains differed for studies reporting severe violence (rather than aggression or hostility) and studies based in inpatient (rather than outpatient) settings. FINDINGS: There were 110 eligible studies reporting on 45,533 individuals, 8,439 (18.5%) of whom were violent. A total of 39,995 (87.8%) were diagnosed with schizophrenia, 209 (0.4%) were diagnosed with bipolar disorder, and 5,329 (11.8%) were diagnosed with other psychoses. Dynamic (or modifiable) risk factors included hostile behaviour, recent drug misuse, non-adherence with psychological therapies (p values<0.001), higher poor impulse control scores, recent substance misuse, recent alcohol misuse (p values<0.01), and non-adherence with medication (p value <0.05). We also examined a number of static factors, the strongest of which were criminal history factors. When restricting outcomes to severe violence, these associations did not change materially. In studies investigating inpatient violence, associations differed in strength but not direction. CONCLUSION: Certain dynamic risk factors are strongly associated with increased violence risk in individuals with psychosis and their role in risk assessment and management warrants further examination.

Systematic review

Unclassified

Do former substance users with psychosis differ in their symptoms or function from non-substance users? A systematic meta-analysis.

Journal The Australian and New Zealand journal of psychiatry
Year 2013
Links Pubmed DOI

This article is included in 1 Broad synthesis 20 Broad syntheses (1 reference)

This article includes 20 Primary studies 20 Primary studies (20 references)

Loading references information
OBJECTIVE: To compare the symptoms and function of patients with psychosis who have ceased using substances to those who have psychosis but do not have a history of substance use. METHOD: The databases EMBASE, MEDLINE and PsycINFO were searched for peer-reviewed publications in English reporting the characteristics of patients with psychotic illness who had stopped using substances and those who had never used substances. The searches yielded 20 articles that met the inclusion criteria. Four key outcome variables - positive symptoms, negative symptoms, depression and global function - and four other outcome measures reported in five or more studies were examined using meta-analysis. RESULTS: Former substance-using patients were significantly younger than non-substance-using patients and were more likely to be male, but did not differ in age at onset of psychosis or in their level of education. There were no significant differences between former substance users and non-substance users in ratings of positive symptoms, negative symptoms, depression or global function. Among first-episode patients there was a trend towards former substance users having less severe depressive symptoms than non-substance users. In contrast, among non-first-episode patients, former substance users had significantly more depressive symptoms than non-substance users. In studies rated as being of higher quality, former substance users had significantly less severe positive symptoms than non-substance users. CONCLUSION: The absence of significant differences between the two groups suggests that a history of substance use is not a poor prognostic indicator for patients who are able to stop using substances.

Systematic review

Unclassified

Effect of illegal substance use on cognitive function in individuals with a psychotic disorder: a review and meta-analysis.

Authors Donoghue K , Doody GA
Journal Neuropsychology
Year 2012
Links Pubmed DOI

Without references

This article is included in 1 Broad synthesis 0 Broad syntheses (1 reference)

Loading references information
OBJECTIVE: Impairment in cognitive function is a core feature of schizophrenia and other psychoses. Substance misuse is associated with impairment in cognitive function in the healthy population. Due to the high prevalence of substance misuse in those with a psychotic disorder, there is concern that a "double deficit" may result in this population. The aim of the current systematic review was to give an overview of the literature, to date, that has investigated the effect of illegal substance abuse or dependence on cognitive function in those with a psychotic disorder and to evaluate the differences and limitations in the methodologies used. METHOD: A systematic review and evaluation of the current literature comparing those with a diagnosis of a psychotic disorder with and without a history of substance abuse or dependence was conducted. A meta-analysis was also conducted to quantitatively assess the association between substance use and cognitive function in those with a psychotic disorder. RESULTS: The current literature investigating the impact of substance misuse on cognitive function in those with a psychotic disorder suffers from many methodological limitations. The results of the meta-analysis show that substance users performed significantly better than nonusers in the cognitive domains of attention and psychomotor speed and verbal memory, with no "double deficit" apparent. CONCLUSIONS: The results of this meta-analysis should be interpreted with caution, in light of the methodological difficulties reviewed.

Systematic review

Unclassified

Cannabis use and duration of untreated psychosis: a systematic review and meta-analysis.

Authors Burns JK
Journal Current pharmaceutical design
Year 2012
Links Pubmed DOI

This article is included in 1 Broad synthesis 28 Broad syntheses (1 reference)

This article includes 28 Primary studies 28 Primary studies (28 references)

Loading references information
BACKGROUND: Duration of untreated psychosis (DUP) is an important predictor of outcome in first-episode psychosis (FEP). Cannabis use is highly prevalent in FEP patients and it is important to evaluate the potential impact of cannabis use on DUP. METHODS: A systematic review of the literature was conducted to identify articles reporting DUP in FEP cannabis users (CU+) and nonusers (CU-) respectively. Studies meeting inclusion criteria were entered into a meta-analysis. In addition, a comparative review was conducted of the relationship between substance use and DUP. RESULTS: Nine studies were identified reporting DUP in CU+ versus CU- patients. Of the pooled sample of 1726 FEP patients, 39% were cannabis users. Although in most studies DUP was shorter in cannabis using patients, meta-analysis did not detect a significant relationship between DUP and cannabis use. A trend towards shorter DUP in substance users was also apparent in the comparative review; although in none of the studies did this association reach statistical significance. DISCUSSION: This review and meta-analysis suggests a trend association between shorter DUP and cannabis use in FEP; especially when cannabis use is defined in terms of current or recent use (rather than lifetime use.) Further research should aim to clarify the relative effects of longstanding versus recent onset cannabis use on neurobiology, pathway to care and outcome in FEP.

Systematic review

Unclassified

The age at onset of psychosis and tobacco use: a systematic meta-analysis.

Journal Social psychiatry and psychiatric epidemiology
Year 2012
Links Pubmed DOI

Without references

This article is included in 1 Broad synthesis 0 Broad syntheses (1 reference)

Loading references information
BACKGROUND: There is a well-established but poorly understood association between tobacco use and psychotic illness. The aim of this study was to determine whether tobacco use is associated with an earlier age at onset of psychotic illness. METHODS: Peer-reviewed publications in English reporting the age at onset of psychosis in tobacco-using and non-tobacco-using groups were located using searches of CINAHL, EMBASE, MEDLINE, PsycINFO and ISI Web of Science, and were supplemented by papers located by manual searches and unpublished data obtained by correspondence with primary researchers. A total of 29 samples reported age at onset data in a consecutive series of patients with a diagnosis of schizophrenia related psychosis or first episode psychosis. Information on study design, study population and effect size was extracted independently by three authors. A random effects meta-analysis was performed. RESULTS: There was no significant difference between smokers and non-smokers in age at the onset of psychosis (standardized mean difference = -0.03). CONCLUSION: Unlike cannabis use, tobacco use is not associated with an earlier onset of psychosis.

Systematic review

Unclassified

Tobacco use before, at, and after first-episode psychosis: a systematic meta-analysis.

Journal The Journal of clinical psychiatry
Year 2012
Links Pubmed DOI

Without references

This article is included in 1 Broad synthesis 0 Broad syntheses (1 reference)

Loading references information
OBJECTIVE: Patients with first-episode psychosis have a high prevalence of tobacco use. We aimed to examine the prevalence and course of tobacco use during early psychosis using meta-analysis. DATA SOURCES: Systematic search of MEDLINE (1948-2011), Embase (1947-2011), CINAHL (1984-2011), PsycINFO (1967-2011), and ISI Web of Science (1900-2011) using the search terms [psychosis OR schizophrenia] AND [tobacco OR smoking OR nicotine]. STUDY SELECTION: We located 10 studies reporting the age at initiation of daily tobacco use and the age at onset of psychosis, 31 studies reporting prevalence of tobacco use in patients with first-episode psychosis, 10 studies comparing smoking to age-/gender-matched controls, and 7 studies reporting prevalence of tobacco use at intervals after treatment. DATA EXTRACTION: The following data were extracted: age at initiation of daily tobacco use and at onset of psychosis, the proportion of patients with first-episode psychosis who used tobacco, the proportion of the general population who used tobacco, and the proportion of patients with psychosis who used tobacco at various intervals after initiation of antipsychotic treatment. RESULTS: The pooled estimate for the interval between initiation of tobacco use and the onset of psychosis was 5.3 years (standardized mean difference = 0.85). The estimated prevalence of tobacco users in first episode of psychosis is 58.9% (95% CI, 54.3%-63.4%). There is a strong association between first-episode psychosis and tobacco use (OR = 6.04; 95% CI, 3.03-12.02) compared with healthy controls. The prevalence of tobacco use at intervals between 6 and 120 months after treatment remained unchanged (OR = 0.996; 95% CI, 0.907-1.094). CONCLUSIONS: Patients with first-episode psychosis tend to have smoked for some years prior to the onset of psychosis, have high prevalence of tobacco use at the time of presenting for treatment, and are much more likely to smoke than aged-matched controls. Their apparent difficulty in quitting has implications for tobacco cessation programs and efforts to reduce cardiovascular disease among people with mental illness.

Systematic review

Unclassified

Biochemical tests of placental function for assessment in pregnancy

blocked
Authors James P Neilson
Journal Cochrane Database of Systematic Reviews
Year 2012
Links Pubmed DOI PubMed Central

This article is included in 1 Broad synthesis 1 Broad syntheses (1 reference)

This article includes 1 Primary study 1 Primary studies (1 reference)

Loading references information
BACKGROUND: Biochemical tests of placental or feto-placental function were widely used in the 1960s and 1970s in high-risk pregnancies to try to predict, and thus try to avoid, adverse fetal outcome. OBJECTIVES: To assess the effects of performing biochemical tests of placental function in high-risk, low-risk, or unselected pregnancies. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (10 May 2012). SELECTION CRITERIA: Controlled trials (randomized or 'quasi-randomized') that compare the use of biochemical tests of placental function in pregnancy with non-use. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data were extracted by the review author. MAIN RESULTS: A single eligible trial of poor quality was identified. It involved 622 women with high-risk pregnancies who had had plasma (o)estriol estimations. Women were allocated to have their (o)estriol results revealed or concealed on the basis of hospital record number (with attendant risk of selection bias). There were no obvious differences in perinatal mortality (relative risk (RR) 0.88, 95% confidence interval (CI) 0.36 to 2.13) or planned delivery (RR 0.97, 95% CI 0.81 to 1.15) between the two groups. AUTHORS' CONCLUSIONS: The available trial data do not support the use of (o)estriol estimation in high-risk pregnancies. The single small trial available does not have the power to exclude a beneficial effect but this is probably of historical interest since biochemical testing has been superseded by biophysical testing in antepartum fetal assessment.

Systematic review

Unclassified

Does giving up substance use work for patients with psychosis? A systematic meta-analysis.

Journal The Australian and New Zealand journal of psychiatry
Year 2012
Links Pubmed DOI

Without references

This article is included in 1 Broad synthesis 0 Broad syntheses (1 reference)

Loading references information
OBJECTIVE: To assess the extent to which ceasing the use of cannabis or other substances reduces the symptoms and social disability associated with psychotic illness. METHODS: The electronic databases CINAHL, EMBASE, MEDLINE and PsycINFO were searched for peer-reviewed publications in English that report data about the characteristics of current and former substance-using patients diagnosed with psychotic illnesses. The searches yielded 328 articles, of which 23 studies met the inclusion criteria. Four key outcome variables; positive symptoms, negative symptoms, ratings of depression and global function, and five other measures of outcome that were reported in five or more studies were examined using meta-analysis. RESULTS: Current substance-using patients were significantly younger than former substance-using patients (standardised mean difference (SMD) = -0.38), but did not differ in age at onset of psychosis, sex, level of education or marital status. Current substance users had higher scores on rating scales of positive symptoms (SMD = 0.29) and depression (SMD = 0.36), and lower scores on global function (SMD = -0.26) when compared with former substance users. There was a significant improvement in the ratings of positive symptoms, mood and global function among patients who stopped using substances during the first episode of psychosis, while improvements in the symptoms of patients with a more established psychotic illness did not reach statistical significance. CONCLUSION: The results suggest that substance use contributes to both the symptoms and the burden of disability experienced by patients with psychosis. Patients in the early stages of psychotic illness should be informed about the benefits of giving up substances earlier, rather than later in the illness. Psychiatric services should regard the treatment of substance use as an integral part of the treatment of psychotic disorders.

Systematic review

Unclassified

Cannabis use and earlier onset of psychosis: a systematic meta-analysis.

Journal Archives of general psychiatry
Year 2011
Links Pubmed DOI

This article is included in 2 Broad syntheses 79 Broad syntheses (2 references)

This article includes 83 Primary studies 79 Primary studies (83 references)

Loading references information
CONTEXT: A number of studies have found that the use of cannabis and other psychoactive substances is associated with an earlier onset of psychotic illness. OBJECTIVE: To establish the extent to which use of cannabis, alcohol, and other psychoactive substances affects the age at onset of psychosis by meta-analysis. DATA SOURCES: Peer-reviewed publications in English reporting age at onset of psychotic illness in substance-using and non-substance-using groups were located using searches of CINAHL, EMBASE, MEDLINE, PsycINFO, and ISI Web of Science. STUDY SELECTION: Studies in English comparing the age at onset of psychosis in cohorts of patients who use substances with age at onset of psychosis in non-substance-using patients. The searches yielded 443 articles, from which 83 studies met the inclusion criteria. DATA EXTRACTION: Information on study design, study population, and effect size were extracted independently by 2 of us. DATA SYNTHESIS: Meta-analysis found that the age at onset of psychosis for cannabis users was 2.70 years younger (standardized mean difference = -0.414) than for nonusers; for those with broadly defined substance use, the age at onset of psychosis was 2.00 years younger (standardized mean difference = -0.315) than for nonusers. Alcohol use was not associated with a significantly earlier age at onset of psychosis. Differences in the proportion of cannabis users in the substance-using group made a significant contribution to the heterogeneity in the effect sizes between studies, confirming an association between cannabis use and earlier mean age at onset of psychotic illness. CONCLUSIONS: The results of meta-analysis provide evidence for a relationship between cannabis use and earlier onset of psychotic illness, and they support the hypothesis that cannabis use plays a causal role in the development of psychosis in some patients. The results suggest the need for renewed warnings about the potentially harmful effects of cannabis.