Annual Research Review: Prevention of psychosis in adolescents - systematic review and meta-analysis of advances in detection, prognosis and intervention / Ana CATALAN in Journal of Child Psychology and Psychiatry, 62-5 (May 2021)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 62-5 (May 2021) . - p.657-673 Titre : Annual Research Review: Prevention of psychosis in adolescents - systematic review and meta-analysis of advances in detection, prognosis and intervention Type de document : Texte imprimé et/ou numérique Auteurs : Ana CATALAN, Auteur ; Gonzalo SALAZAR DE PABLO, Auteur ; Julio VAQUERIZO SERRANO, Auteur ; Pierluca MOSILLO, Auteur ; Helen BALDWIN, Auteur ; Aranzazu FERNANDEZ-RIVAS, Auteur ; Carmen MORENO, Auteur ; Celso ARANGO, Auteur ; Christoph U CORRELL, Auteur ; Ilaria BONOLDI, Auteur ; Paolo FUSAR-POLI, Auteur Article en page(s) : p.657-673 Langues : Anglais (eng) Mots-clés : Psychosis  adolescence  childhood  clinical high-risk state for psychosis  evidence  first-episode  meta-analysis  prediction  prevention  psychosis risk  schizophrenia Index. décimale : PER Périodiques Résumé : BACKGROUND: The clinical high-risk state for psychosis (CHR-P) paradigm has facilitated the implementation of psychosis prevention into clinical practice; however, advancements in adolescent CHR-P populations are less established. METHODS: We performed a PRISMA/MOOSE-compliant systematic review of the Web of Science database, from inception until 7 October 2019, to identify original studies conducted in CHR-P children and adolescents (mean age <18 years). Findings were systematically appraised around core themes: detection, prognosis and intervention. We performed meta-analyses (employing Q statistics and I (2) test) regarding the proportion of CHR-P subgroups, the prevalence of baseline comorbid mental disorders, the risk of psychosis onset and the type of interventions received at baseline. Quality assessment and publication bias were also analysed. RESULTS: Eighty-seven articles were included (n = 4,667 CHR-P individuals). Quality of studies ranged from 3.5 to 8 (median 5.5) on a modified Newcastle-Ottawa scale. Detection: Individuals were aged 15.6 ± 1.2 years (51.5% males), mostly (83%) presenting with attenuated positive psychotic symptoms. CHR-P psychometric accuracy improved when caregivers served as additional informants. Comorbid mood (46.4%) and anxiety (31.4%) disorders were highly prevalent. Functioning and cognition were impaired. Neurobiological studies were inconclusive. PROGNOSIS: Risk for psychosis was 10.4% (95%CI: 5.8%-18.1%) at 6 months, 20% (95%CI: 15%-26%) at 12 months, 23% (95%CI: 18%-29%) at 24 months and 23.3% (95%CI: 17.3%-30.7%) at ?36 months. INTERVENTIONS: There was not enough evidence to recommend one specific treatment (including cognitive behavioural therapy) over the others (including control conditions) to prevent the transition to psychosis in this population. Randomised controlled trials suggested that family interventions, cognitive remediation and fish oil supplementation may improve cognition, symptoms and functioning. At baseline, 30% of CHR-P adolescents were prescribed antipsychotics and 60% received psychotherapy. CONCLUSIONS: It is possible to detect and formulate a group-level prognosis in adolescents at risk for psychosis. Future interventional research is required. En ligne : http://dx.doi.org/10.1111/jcpp.13322 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=445 [article] Annual Research Review: Prevention of psychosis in adolescents - systematic review and meta-analysis of advances in detection, prognosis and intervention [Texte imprimé et/ou numérique] / Ana CATALAN, Auteur ; Gonzalo SALAZAR DE PABLO, Auteur ; Julio VAQUERIZO SERRANO, Auteur ; Pierluca MOSILLO, Auteur ; Helen BALDWIN, Auteur ; Aranzazu FERNANDEZ-RIVAS, Auteur ; Carmen MORENO, Auteur ; Celso ARANGO, Auteur ; Christoph U CORRELL, Auteur ; Ilaria BONOLDI, Auteur ; Paolo FUSAR-POLI, Auteur . - p.657-673. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 62-5 (May 2021) . - p.657-673 Mots-clés : Psychosis  adolescence  childhood  clinical high-risk state for psychosis  evidence  first-episode  meta-analysis  prediction  prevention  psychosis risk  schizophrenia Index. décimale : PER Périodiques Résumé : BACKGROUND: The clinical high-risk state for psychosis (CHR-P) paradigm has facilitated the implementation of psychosis prevention into clinical practice; however, advancements in adolescent CHR-P populations are less established. METHODS: We performed a PRISMA/MOOSE-compliant systematic review of the Web of Science database, from inception until 7 October 2019, to identify original studies conducted in CHR-P children and adolescents (mean age <18 years). Findings were systematically appraised around core themes: detection, prognosis and intervention. We performed meta-analyses (employing Q statistics and I (2) test) regarding the proportion of CHR-P subgroups, the prevalence of baseline comorbid mental disorders, the risk of psychosis onset and the type of interventions received at baseline. Quality assessment and publication bias were also analysed. RESULTS: Eighty-seven articles were included (n = 4,667 CHR-P individuals). Quality of studies ranged from 3.5 to 8 (median 5.5) on a modified Newcastle-Ottawa scale. Detection: Individuals were aged 15.6 ± 1.2 years (51.5% males), mostly (83%) presenting with attenuated positive psychotic symptoms. CHR-P psychometric accuracy improved when caregivers served as additional informants. Comorbid mood (46.4%) and anxiety (31.4%) disorders were highly prevalent. Functioning and cognition were impaired. Neurobiological studies were inconclusive. PROGNOSIS: Risk for psychosis was 10.4% (95%CI: 5.8%-18.1%) at 6 months, 20% (95%CI: 15%-26%) at 12 months, 23% (95%CI: 18%-29%) at 24 months and 23.3% (95%CI: 17.3%-30.7%) at ?36 months. INTERVENTIONS: There was not enough evidence to recommend one specific treatment (including cognitive behavioural therapy) over the others (including control conditions) to prevent the transition to psychosis in this population. Randomised controlled trials suggested that family interventions, cognitive remediation and fish oil supplementation may improve cognition, symptoms and functioning. At baseline, 30% of CHR-P adolescents were prescribed antipsychotics and 60% received psychotherapy. CONCLUSIONS: It is possible to detect and formulate a group-level prognosis in adolescents at risk for psychosis. Future interventional research is required. En ligne : http://dx.doi.org/10.1111/jcpp.13322 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=445

Pharmacological and non-pharmacological interventions for irritability in autism spectrum disorder: a systematic review and meta-analysis with the GRADE assessment / Hangnyoung CHOI in Molecular Autism, 15 (2024)  

Public ISBD [article]  inMolecular Autism > 15 (2024) . - 7p. Titre : Pharmacological and non-pharmacological interventions for irritability in autism spectrum disorder: a systematic review and meta-analysis with the GRADE assessment Type de document : Texte imprimé et/ou numérique Auteurs : Hangnyoung CHOI, Auteur ; Jae Han KIM, Auteur ; Hee Sang YANG, Auteur ; Jong Yeob KIM, Auteur ; Samuele CORTESE, Auteur ; Lee SMITH, Auteur ; Ai KOYANAGI, Auteur ; Elena DRAGIOTI, Auteur ; Joaquim RADUA, Auteur ; Paolo FUSAR-POLI, Auteur ; Jae Il SHIN, Auteur ; Keun-Ah CHEON, Auteur ; Marco SOLMI, Auteur Article en page(s) : 7p. Langues : Anglais (eng) Mots-clés : Male  Humans  Female  GRADE Approach  Aripiprazole  Risperidone  Autism Spectrum Disorder  Autism spectrum disorder  Irritability  Meta-analysis  Randomized controlled trial  Systematic review  ADHD. PFP received honoraria/has been a consultant for Angelini, Menarini,  Lundbeck, and Sunovion. MS received honoraria/has been a consultant for ABBVie,  Angelini, Lundbeck, and Otsuka. Index. décimale : PER Périodiques Résumé : BACKGROUND: Numerous interventions for irritability in autism spectrum disorder (ASD) have been investigated. We aimed to appraise the magnitude of pharmacological and non-pharmacological interventions for irritability in ASD without any restrictions in terms of eligible interventions. METHODS: We systematically searched PubMed/MEDLINE, Scopus, and Web of Science until April 15, 2023. We included randomized controlled trials (RCTs) with a parallel design that examined the efficacy of interventions for the treatment of irritability in patients of any age with ASD without any restrictions in terms of eligible interventions. We performed a random-effects meta-analysis by pooling effect sizes as Hedges' g. We classified assessed interventions as follows: pharmacological monotherapy, risperidone plus adjuvant therapy versus risperidone monotherapy, non-pharmacological intervention, and dietary intervention. We utilized the Cochrane tool to evaluate the risk of bias in each study and the GRADE approach to assess the certainty of evidence for each meta-analyzed intervention. RESULTS: Out of 5640 references, we identified 60 eligible articles with 45 different kinds of interventions, including 3531 participants, of which 80.9% were males (mean age [SD] = 8.79 [3.85]). For pharmacological monotherapy, risperidone (Hedges' g -?0.857, 95% CI -?1.263 to -?0.451, certainty of evidence: high) and aripiprazole (Hedges' g -?0.559, 95% CI -?0.767 to -?0.351, certainty of evidence: high) outperformed placebo. Among the non-pharmacological interventions, parent training (Hedges' g -?0.893, 95% CI -?1.184 to -?0.602, certainty of evidence: moderate) showed a significant result. None of the meta-analyzed interventions yielded significant effects among risperidone?+?adjuvant therapy and dietary supplementation. However, several novel molecules in augmentation to risperidone outperformed risperidone monotherapy, yet from one RCT each. LIMITATIONS: First, various tools have been utilized to measure the irritability in ASD, which may contribute to the heterogeneity of the outcomes. Second, meta-analyses for each intervention included only a small number of studies and participants. CONCLUSIONS: Only risperidone, aripiprazole among pharmacological interventions, and parent training among non-pharmacological interventions can be recommended for irritability in ASD. As an augmentation to risperidone, several novel treatments show promising effects, but further RCTs are needed to replicate findings. Trial registration PROSPERO, CRD42021243965. En ligne : https://dx.doi.org/10.1186/s13229-024-00585-6 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=538 [article] Pharmacological and non-pharmacological interventions for irritability in autism spectrum disorder: a systematic review and meta-analysis with the GRADE assessment [Texte imprimé et/ou numérique] / Hangnyoung CHOI, Auteur ; Jae Han KIM, Auteur ; Hee Sang YANG, Auteur ; Jong Yeob KIM, Auteur ; Samuele CORTESE, Auteur ; Lee SMITH, Auteur ; Ai KOYANAGI, Auteur ; Elena DRAGIOTI, Auteur ; Joaquim RADUA, Auteur ; Paolo FUSAR-POLI, Auteur ; Jae Il SHIN, Auteur ; Keun-Ah CHEON, Auteur ; Marco SOLMI, Auteur . - 7p. Langues : Anglais (eng) in Molecular Autism > 15 (2024) . - 7p. Mots-clés : Male  Humans  Female  GRADE Approach  Aripiprazole  Risperidone  Autism Spectrum Disorder  Autism spectrum disorder  Irritability  Meta-analysis  Randomized controlled trial  Systematic review  ADHD. PFP received honoraria/has been a consultant for Angelini, Menarini,  Lundbeck, and Sunovion. MS received honoraria/has been a consultant for ABBVie,  Angelini, Lundbeck, and Otsuka. Index. décimale : PER Périodiques Résumé : BACKGROUND: Numerous interventions for irritability in autism spectrum disorder (ASD) have been investigated. We aimed to appraise the magnitude of pharmacological and non-pharmacological interventions for irritability in ASD without any restrictions in terms of eligible interventions. METHODS: We systematically searched PubMed/MEDLINE, Scopus, and Web of Science until April 15, 2023. We included randomized controlled trials (RCTs) with a parallel design that examined the efficacy of interventions for the treatment of irritability in patients of any age with ASD without any restrictions in terms of eligible interventions. We performed a random-effects meta-analysis by pooling effect sizes as Hedges' g. We classified assessed interventions as follows: pharmacological monotherapy, risperidone plus adjuvant therapy versus risperidone monotherapy, non-pharmacological intervention, and dietary intervention. We utilized the Cochrane tool to evaluate the risk of bias in each study and the GRADE approach to assess the certainty of evidence for each meta-analyzed intervention. RESULTS: Out of 5640 references, we identified 60 eligible articles with 45 different kinds of interventions, including 3531 participants, of which 80.9% were males (mean age [SD] = 8.79 [3.85]). For pharmacological monotherapy, risperidone (Hedges' g -?0.857, 95% CI -?1.263 to -?0.451, certainty of evidence: high) and aripiprazole (Hedges' g -?0.559, 95% CI -?0.767 to -?0.351, certainty of evidence: high) outperformed placebo. Among the non-pharmacological interventions, parent training (Hedges' g -?0.893, 95% CI -?1.184 to -?0.602, certainty of evidence: moderate) showed a significant result. None of the meta-analyzed interventions yielded significant effects among risperidone?+?adjuvant therapy and dietary supplementation. However, several novel molecules in augmentation to risperidone outperformed risperidone monotherapy, yet from one RCT each. LIMITATIONS: First, various tools have been utilized to measure the irritability in ASD, which may contribute to the heterogeneity of the outcomes. Second, meta-analyses for each intervention included only a small number of studies and participants. CONCLUSIONS: Only risperidone, aripiprazole among pharmacological interventions, and parent training among non-pharmacological interventions can be recommended for irritability in ASD. As an augmentation to risperidone, several novel treatments show promising effects, but further RCTs are needed to replicate findings. Trial registration PROSPERO, CRD42021243965. En ligne : https://dx.doi.org/10.1186/s13229-024-00585-6 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=538

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