The reported prevalence of depression in psoriasis varies substantially. This study aims to determine the prevalence and odds of depressive symptoms and clinical depression in psoriasis. A systematic ...literature search was conducted. Mean questionnaire values and proportions for depressive symptoms and clinical depression were pooled according to different assessment methods. In controlled studies, standardized mean differences (SMDs) and odds ratio (OR) compared depression in psoriasis patients with controls using the random-effect model. The majority of the 98 eligible studies were conducted in tertiary centers without a control group. The prevalence of depressive symptoms was 28% using questionnaires and the prevalence of clinical depression was 12% using International Classification of Diseases codes, 19% using Diagnostic and Statistical Manual of Mental Disorders IV, and 9% for antidepressant use. Psoriasis patients had significantly more depressive symptoms (SMD 1.16; 95% confidence interval (CI) 0.67–1.66), and population-based studies showed that they were at least one and a half times more likely to experience depression (OR 1.57; 95% CI 1.40–1.76) and used more antidepressants than did controls (OR 4.24, 95% CI 1.53–11.76). More than 10% of psoriasis patients suffer from clinical depression, and twice as many have depressive symptoms. The high prevalence of these symptoms is likely to be affected by the tertiary study populations and differential misclassification using questionnaires, where psoriasis-related symptoms may be detected as depressive symptoms.
Myeloproliferative neoplasms (MPNs) are the most common cause of Budd-Chiari syndrome (BCS) and nonmalignant, noncirrhotic portal vein thrombosis (PVT). In this meta-analysis, we determined the ...prevalence of MPNs and their subtypes as well as JAK2V617F and its diagnostic role in these uncommon disorders. MEDLINE and EMBASE databases were searched. Prevalence of MPNs, JAK2V617F, and MPN subtypes were calculated using a random-effects model. A total of 1062 BCS and 855 PVT patients were included. In BCS, mean prevalence of MPNs and JAK2V617F was 40.9% (95% CI, 32.9%-49.5%) and 41.1% (95% CI, 32.3%-50.6%), respectively. In PVT, mean prevalence of MPNs and JAK2V617F was 31.5% (95% CI, 25.1%-38.8%) and 27.7% (95% CI, 20.8%-35.8%), respectively. JAK2V617F and MPNs were more frequent in BCS compared with PVT (P = .03 and P = .09, respectively). Polycythemia vera was more prevalent in BCS than in PVT (P = .001). JAK2V617F screening in splanchnic vein thrombosis (SVT) patients without typical hematologic MPN features identified MPN in 17.1% and 15.4% of screened BCS and PVT patients, respectively. These results demonstrate a high prevalence of MPNs and JAK2V617F in SVT patients and show differences in underlying etiology between these disorders. Furthermore, these results validate routine inclusion of JAK2V617F in the diagnostic workup of SVT patients.
The aim of the current meta-analysis was to aggregate concurrent and longitudinal empirical research on associations between the interparental relationship and both children's maladjustment (i.e., ...externalizing and internalizing symptoms) and children's responses to interparental conflict (i.e., emotional, behavioral, cognitive, and physiological). Based on major theoretical frameworks, we distinguished between six dimensions of the interparental relationship: relationship quality, conflict frequency, hostile, disengaged, and unconstructive forms of conflict, and child-related conflict. A final selection of 169 studies for child maladjustment and 61 studies for child responses to conflict were included. The findings revealed by the expansive and fine-grained approach of this meta-analysis support and challenge theoretical hypotheses about the relative predictive value of dimensions of the interparental relationship for children's functioning. Although hostility was specifically more strongly associated with children's externalizing behavior and emotional responses to conflict, disengaged and unconstructive conflict behavior posed similar risks for the other domains of child functioning. In addition, relationship quality, conflict frequency, and child-related conflict warrant more attention in theoretical frameworks, as these dimensions posed similar risks to child functioning as the different forms of conflict. Moreover, most associations between the interparental relationship and child functioning endured over time. Also, developmental and gender differences appeared to depend on the specific forms of interparental conflict and the domain of child functioning. In sum, the results support the growing consensus that prevention and intervention programs aimed at children's mental health could benefit from an alternative or additional focus on the interparental relationship.
Public Significance Statement
This meta-analysis pooled findings from previous research on associations between different aspects of the interparental relationship and children's maladjustment (i.e., externalizing and internalizing problems) and responses to interparental conflict (i.e., emotional, behavioral, and physiological reactivity, and cognitive appraisals of the interparental subsystem). The findings highlight the importance of both the general quality of the relationship between parents as well as five aspects of interparental conflicts (i.e., conflict frequency, the level of hostile, disengaged and unconstructive conflict behavior, and the amount of child-related conflicts) as robust predictors of children's maladjustment, concurrently and over time. Moreover, the findings confirm that children's emotional and behavioral reactivity to interparental conflicts, and their cognitive appraisals of the interparental subsystem, are fruitful directions for understanding why interparental conflict leads to maladjustment in children.
Despite the frequently reported association of characteristics of assessment policies with academic performance, the mechanisms through which these policies affect performance are largely unknown. ...Therefore, the current research investigated performance, motivation and self-regulation for two groups of students following the same statistics course, but under two assessment policies: education and child studies (ECS) students studied under an assessment policy with relatively higher stakes, a higher performance standard and a lower resit standard, compared with Psychology students. Results show similar initial performance, but more use of resits and higher final performance (post-resit) under the ECS policy compared with the psychology policy. In terms of motivation and self-regulation, under the ECS policy significantly higher minimum grade goals, performance self-efficacy, task value, time and study environment management, and test anxiety were observed, but there were no significant differences in aimed grade goals, academic self-efficacy and effort regulation. The relations of motivational and self-regulatory factors with academic performance were similar between both assessment policies. Thus, educators should be keenly aware of how characteristics of assessment policies are related to students' motivation, self-regulation and academic performance.
After total hip arthroplasty (THA), patients today (who tend to be younger and more active than those who previously underwent this surgical procedure) have high expectations regarding functional ...outcome. Therefore, patients need to be well informed about recovery of physical functioning after THA.
The purpose of this study was to review publications on recovery of physical functioning after THA and examine the degree of recovery with regard to 3 aspects of functioning (ie, perceived physical functioning, functional capacity to perform activities, and actual daily activity in the home situation).
Data were obtained from the MEDLINE and EMBASE databases from inception to July 2009, and references in identified articles were tracked.
Prospective studies with a before-after design were included. Patients included in the analysis had to have primary THA for osteoarthritis.
Two reviewers independently checked the inclusion criteria, conducted the risk of bias assessment, and extracted the results. Data were pooled in a meta-analysis using a random-effects model.
A total of 31 studies were included. For perceived physical functioning, patients recovered from less than 50% preoperatively to about 80% of that of controls (individuals who were healthy) 6 to 8 months postsurgery. On functional capacity, patients recovered from 70% preoperatively to about 80% of that of controls 6 to 8 months postsurgery. For actual daily activity, patients recovered from 80% preoperatively to 84% of that of controls at 6 months postsurgery.
Only a few studies were retrieved that investigated the recovery of physical functioning longer than 8 months after surgery.
Compared with the preoperative situation, the 3 aspects of physical functioning showed varying degrees of recovery after surgery. At 6 to 8 months postoperatively, physical functioning had generally recovered to about 80% of that of controls.
Bivariate random effects meta-analysis of diagnostic tests is becoming a well established approach when studies present one two-by-two table or one pair of sensitivity and specificity. When studies ...present multiple thresholds for test positivity, usually meta-analysts reduce the data to a two-by-two table or take one threshold value at a time and apply the well developed meta-analytic approaches. However, this approach does not fully exploit the data.
In this paper we generalize the bivariate random effects approach to the situation where test results are presented with k thresholds for test positivity, resulting in a 2 by (k+1) table per study. The model can be fitted with standard likelihood procedures in statistical packages such as SAS (Proc NLMIXED). We follow a multivariate random effects approach; i.e., we assume that each study estimates a study specific ROC curve that can be viewed as randomly sampled from the population of all ROC curves of such studies. In contrast to the bivariate case, where nothing can be said about the shape of study specific ROC curves without additional untestable assumptions, the multivariate model can be used to describe study specific ROC curves. The models are easily extended with study level covariates.
The method is illustrated using published meta-analysis data. The SAS NLMIXED syntax is given in the appendix.
We conclude that the multivariate random effects meta-analysis approach is an appropriate and convenient framework to meta-analyse studies with multiple threshold without losing any information by dichotomizing the test results.
Background: Posttraumatic stress disorder (PTSD) is common in patients with personality disorders. This comorbidity is accompanied by a lower quality of life, and a higher risk of suicide attempts ...than patients with only one of these diagnoses.
Objective: The aim of this systematic review and meta-analysis was to evaluate the scientific evidence of the efficacy of PTSD treatments for this population.
Method: A literature search was performed from 1946 through June 2020. Standardized mean effect sizes of psychotherapy for PTSD were computed.
Results: The literature search revealed that psychotherapy was the only intervention that was systematically explored. Fourteen studies were included. In 12 of these studies solely patients with borderline personality disorder participated. Analysis of the four RCTs showed a significant, moderate to high standardized effect size for reducing PTSD symptom severity (Hedges' g = 0.54), with effects being maintained at least 3 months (Hedges' g = 0.82). Effect sizes for all studies were also significant, with moderate to high standardized values for symptoms of PTSD (Hedges' g = 1.04). PTSD improvements were again maintained at 3-month follow-up and beyond (Hedges' g = 0.98). In addition, a significant decrease in symptoms of depression, anxiety, borderline symptoms, and PTSD in patients with borderline personality disorder could be revealed for all studies (Hedges' g 0.48-1.04). No increase in self-injurious behaviour, suicide attempts, or hospitalization was observed, while the mean weighted dropout rate during PTSD treatment was 17%.
Conclusions: Psychotherapy for PTSD is efficacious and safe for patients with borderline personality disorder and should not be withheld from these vulnerable individuals.
We updated the meta-analysis published by McDonald et al. Chest 2002;122;1535–1542 by reviewing the effectiveness of air purification for the treatment of home-related allergic asthma (dust mite, ...dog, cat, and cockroach). We analysed the trials included by McDonald et al. as well as studies published since 2000. Data on asthma symptoms scores (ASS), medication use, forced expiratory volume in 1 s as a percentage of the predicted value (FEV 1 %pred), histamine provocative concentration causing a 20% reduction in FEV 1 (PC 20 ), Asthma Quality of Life Questionnaire (AQLQ) scores, and fractional exhaled nitric oxide (FeNO) levels were extracted. The effectiveness was examined using metafor (registered in Prospero CRD42019127227). Ten trials including a total of 482 patients (baseline characteristics: mean FEV 1 %pred 83.2%, I 2 = 96.7%; mean PC 20 4.93 mg/mL, I 2 = 44.0%; mean AQLQ 4.67 max. 7, I 2 = 93.7%; mean FeNO 36.5 ppb, I 2 = 0%) were included. We assessed the mean differences in the AQLQ scores as +0.36 (95% CI 0.10 to 0.62, p = 0.01, n = 302, I 2 = 0%) and the FeNO levels as –6.67 ppb (95% CI –10.56 to –2.77, p = 0.0008, n = 304, I 2 = 0%). The standardised mean differences in all other health outcomes were not significant (ASS –0.68, p = 0.20; medication use: –0.01, p = 0.94; FEV 1 %pred –0.11, p = 0.34; PC 20 +0.24, p = 0.53). We found statistically significant mean differences in the AQLQ scores and FeNO levels in patients with predominantly mild to moderate asthma at baseline. A large trial reported great improvement in the subgroup of patients receiving Global Initiative for Asthma step 4 therapy. We recommend that future studies on air purification focus on patients with severe and poorly controlled allergic asthma.
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