Could Animal-Assisted Therapy Help to Reduce Coercive Treatment in Psychiatry?

Review: Animal-assisted intervention for children with attention-deficit/hyperactivity disorder - a systematic review and meta-analysis

BACKGROUND

Animal-assisted interventions (AAIs) have emerged as a promising nonpharmacological intervention option for children diagnosed with attention-deficit/hyperactivity disorder (ADHD). However, recent systematic reviews have been primarily narrative. Additionally, the pooled effectiveness of AAIs was absent from these systematic reviews.

METHODS

We conducted a comprehensive systematic review and meta-analysis, searching multiple databases, including Web of Science, MEDLINE, CINAHL, Scopus, PsycINFO, EMBASE and Cochrane, from inception of the databases to March 2024. We retrieved 17 randomised controlled trials or quasi-experimental studies and used Review Manager 5.4.1 software to perform a meta-analysis of the effects of AAIs in treating children with ADHD. We conducted a set of random-effects meta-analyses to estimate standardised mean differences (SMD) with 95% confidence intervals (CI) using subgroup data by different outcome domains extracted from eight randomised controlled trials, in relation to changes in behavioural, mental and physical functioning in a total of 307 children with ADHD before and after the intervention.

RESULTS

In comparison with non-AAI groups, AAIs significantly improved attention problems in children with ADHD (SMD = -0.42, 95% CI = -0.71 to -0.13), self-esteem (0.46, 0.14 to 0.78), learning and cognition problems (-0.69, -0.98 to -0.39) and motor proficiency (0.77, 0.11 to 1.42). The pooled effect of AAIs on the severity of ADHD symptoms in the experimental group was not significantly different from the effect of conventional treatments in the control group (0.10, -0.31 to 0.52). Similarly, AAIs had no significant positive effects on social interaction (-0.22, -0.51 to 0.06), social skills (-0.32, -0.87 to 0.24), problematic behaviours (-0.10, -0.54 to 0.35) or emotional problems, including depression and anxiety (-0.13, -0.51 to 0.24).

CONCLUSIONS

As an ADHD management strategy complementary to gold-standard approaches, such as medication or multimodal interventions, AAIs did not appear to be more effective in improving the majority of core ADHD outcomes in children. Future studies should incorporate rigorous study designs with large sample sizes and a standard protocol to achieve more valid and reliable conclusion.

Feasibility of Identifying Factors Related to Alzheimer's Disease and Related Dementia in Real-World Data

A comprehensive view of factors associated with AD/ADRD will significantly aid in studies to develop new treatments for AD/ADRD and identify high-risk populations and patients for prevention efforts. In our study, we summarized the risk factors for AD/ADRD by reviewing existing meta-analyses and review articles on risk and preventive factors for AD/ADRD. In total, we extracted 477 risk factors in 10 categories from 537 studies. We constructed an interactive knowledge map to disseminate our study results. Most of the risk factors are accessible from structured Electronic Health Records (EHRs), and clinical narratives show promise as information sources. However, evaluating genomic risk factors using RWD remains a challenge, as genetic testing for AD/ADRD is still not a common practice and is poorly documented in both structured and unstructured EHRs. Considering the constantly evolving research on AD/ADRD risk factors, literature mining via NLP methods offers a solution to automatically update our knowledge map.

[Schema Therapy with Sheep: Animal-assisted Intervention in Schema Therapeutic Psychiatric Addiction Treatment]

AIM OF THE STUDY

Schematherapy is often used in addiction treatment. The question is whether animal-assisted interventions can improve the effects.

METHOD

During an inpatient psychiatric stay with a schematherapeutic focus, an animal-assisted intervention with sheep was implemented. A case report is presented.

RESULTS

After the intervention, the individual mode model of the presented patient shows significant changes towards a strengthening the healthy adult and happy child mode and a reduction of dysfunctional modes.

CONCLUSION

The animal-assisted intervention, embedded in a schematherapeutic context, was experienced in this patient as well implementable and impressively effective with regard to a modification of the mode model.