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Rotella F, Falone A, Cassioli E, Mannucci E, Ricca V, Del Monaco F. The effect of differences in trial design on estimates of efficacy of olanzapine in randomized studies. Psychiatry Res 2024; 336:115895. [PMID: 38642423 DOI: 10.1016/j.psychres.2024.115895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Differences in trial design may affect estimates of efficacy of psychotropic drugs. The purpose of this meta-analysis is to evaluate whether the use of Olanzapine (OLZ) as either investigational or control drug affects the observed efficacy of OLZ. METHODS We performed a search for Randomized-Controlled Trials (RCTs) in which the efficacy of OLZ is assessed in patients with schizophrenia or schizoaffective disorder. We assessed overall efficacy of OLZ and performed subgroup analyses of studies with OLZ as intervention or comparator. Mixed-effect meta-regression analyses were performed. RESULTS Of the 25 RCTs included, OLZ was considered as investigational drug or active control in 13 and 12 studies, respectively. The reduction of PANSS score was greater in trials in which OLZ was used as investigational drug. Multivariate meta-regression models showed that a higher PANSS score at baseline and trial duration were the main predictors of greater PANSS score reduction. CONCLUSIONS Trials with OLZ used as investigational drug differ from those of trials with OLZ as comparator for baseline PANSS scores and study duration; these differences may produce differences in estimates of efficacy. As a consequence, the severity of illness at enrollment and trial duration should be carefully considered to ensure the reliability of indirect comparisons among antipsychotics.
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Affiliation(s)
- F Rotella
- Department of Health Sciences, University of Florence, Psychiatry Unit, AOU Careggi, Largo Brambilla 3, 50134, Florence, Italy.
| | - A Falone
- Department of Health Sciences, University of Florence, Psychiatry Unit, AOU Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - E Cassioli
- Department of Health Sciences, University of Florence, Psychiatry Unit, AOU Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - E Mannucci
- Department of Health Sciences, University of Florence, Diabetology, AOU Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - V Ricca
- Department of Health Sciences, University of Florence, Psychiatry Unit, AOU Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - F Del Monaco
- Department of Health Sciences, University of Florence, Psychiatry Unit, AOU Careggi, Largo Brambilla 3, 50134, Florence, Italy
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Fei L, Bozza B, Melani G, Righi L, Santarelli G, Boy OB, Benedetti D, Falone A, Flaccomio D, Giuranno G, Martelli M, Merola P, Moretti S, Ndoci E, Pecoraro V, Siviglia S, Berni A, Fanelli A, Giovagnini E, Morettini A, Nozzoli C, Para O, Rostagno C, Tozzetti C. SSRIs in the course of COVID-19 pneumonia: Evidence of effectiveness of antidepressants on acute inflammation. A retrospective study. Hum Psychopharmacol 2024; 39:e2887. [PMID: 38059650 DOI: 10.1002/hup.2887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 12/08/2023]
Abstract
INTRODUCTION Relationships between inflammation and mood have been observed in terms of pro-inflammatory effects induced by depressive conditions and, in parallel, by an antidepressant-induced favorable effect on the recovery of inflammatory states. Selective serotonin reuptake inhibitor (SSRI) drugs were hypothesized to improve the prognosis of COVID-19 pneumonia, a typical acute inflammation, in terms of decreased mortality rate and pro-inflammatory cytokine serum levels. METHODS The medical records of COVID-19 pneumonia inpatients at Careggi University Hospital (Florence) were analyzed for prognosis and Interleukin 6 (IL-6) after admission for over a period of 22 months. Medical records of patients treated at admission and not discontinued until discharge with an SSRI or with vortioxetine were identified. Two groups, one treated with antidepressants, the other not treated, were evaluated according to the mentioned parameters. Multiple linear regression and logistic regression were performed. RESULTS The entire sample composed of 1236 records (recovered patients 77.1%, deceased patients 22.9%). The treated group (n = 107) had a better prognosis than the untreated group in spite of age and comorbidity both being greater than in the untreated group. Correspondingly, IL-6 levels in the treated group were significantly lower (p < 0.01) than the levels in the untreated group, in every comparison. CONCLUSIONS Outcomes of this study support the hypothesis of the favorable influence of some antidepressants on the prognosis of COVID-19, possibly mediated by IL-6 modulation. Reduction in acute inflammation induced by the action of antidepressants was confirmed.
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Affiliation(s)
- Leonardo Fei
- Careggi University Hospital (IT), Chair of Psycho-Oncology, Florence, Italy
| | - Bernardo Bozza
- School of Psychiatry, University of Florence (IT), Florence, Italy
| | - Giulia Melani
- School of Psychiatry, University of Florence (IT), Florence, Italy
| | | | | | | | - Davide Benedetti
- School of Psychiatry, University of Florence (IT), Florence, Italy
| | - Andrea Falone
- School of Psychiatry, University of Florence (IT), Florence, Italy
| | - Dario Flaccomio
- School of Psychiatry, University of Florence (IT), Florence, Italy
| | | | - Michela Martelli
- School of Psychiatry, University of Florence (IT), Florence, Italy
| | - Pierpaolo Merola
- School of Psychiatry, University of Florence (IT), Florence, Italy
| | | | - Endrit Ndoci
- School of Psychiatry, University of Florence (IT), Florence, Italy
| | | | - Serena Siviglia
- School of Psychiatry, University of Florence (IT), Florence, Italy
| | - Andrea Berni
- Careggi University Hospital (IT), Florence, Italy
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Merola GP, Boy OB, Fascina I, Pecoraro V, Falone A, Patti A, Santarelli G, Cicero DC, Ballerini A, Ricca V. Aberrant Salience Inventory: A meta-analysis to investigate its psychometric properties and identify screening cutoff scores. Scand J Psychol 2023; 64:734-745. [PMID: 37243361 DOI: 10.1111/sjop.12931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023]
Abstract
INTRODUCTION The Aberrant Salience Inventory (ASI) is a useful tool to measure salience abnormalities among the general population. There is strong clinical and scientific evidence that salience alteration is linked to psychosis. To the present day, no meta-analysis evaluating ASI's psychometric properties and screening potential has been published. MATERIALS AND METHODS PubMed, Google Scholar, Scopus, and Embase were searched using terms including "psychosis," "schizophrenia," and "Aberrant Salience Inventory." Observational and experimental studies employing ASI on populations of non-psychotic controls and patients with psychosis were included. ASI scores and other demographic measures (age, gender, ethnicity) were extracted as outcomes. Individual patients' data (IPD) were collected. Exploratory factor analysis (EFA) was performed on the IPD. RESULTS Eight articles were finally included in the meta-analysis. ASI scores differ significantly between psychotic and non-psychotic populations; a novel three-factor model is proposed regarding subscales structure. Theoretical positive predictive values (PPVs) and negative predictive values (NPVs) were calculated and presented together with different cutoff points depending on preselected specific populations of interest. DISCUSSION PPV and NPV values reached levels adequate for ASI to be considered a viable screening tool for psychosis. The factor analysis highlights the presence of a novel subscale that was named "Unveiling experiences." Implications regarding the meaning of the new factor structure are discussed, as well as ASI's potential as a screening tool.
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Affiliation(s)
| | - Ottone Baccaredda Boy
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Isotta Fascina
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Vincenzo Pecoraro
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Andrea Falone
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Andrea Patti
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Gabriele Santarelli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Andrea Ballerini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
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Campanino C, Falone A, Rossi E, Angeletti LL, Cassioli E, Gemignani S, Brogioni G, Castellini G, Bonaccorsi G, Mannucci E, Ricca V, Rotella F. Health literacy in female patients affected by anorexia nervosa and bulimia nervosa: a cross-sectional study with pair-matched controls. Eat Weight Disord 2023; 28:59. [PMID: 37439911 DOI: 10.1007/s40519-023-01588-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/06/2023] [Indexed: 07/14/2023] Open
Abstract
PURPOSE Health Literacy (HL) consists in all the skills and knowledges used by people to understand and seek health-related information. Inadequate levels of HL substantially affect many different aspects of health. The primary aim of the present study was to assess levels of HL in female patients with anorexia nervosa (AN) and bulimia nervosa (BN), compared with matched control subjects. METHODS A consecutive series of 64 female patients with AN and BN (mean age 23.1 ± 7.0) was enrolled, matched with 64 female control subjects (mean age 23.7 ± 7.1). Both groups completed the Health Literacy Survey Questionnaire (HLS-EU-Q16) and the Newest Vital Sign (NVS), which evaluate subjective and objective HL level respectively. RESULTS Patients with AN and BN showed lower levels of subjective HL (10.0 ± 3.5 vs. 11.3 ± 3.0) and higher levels of objective HL (5.0 ± 1.3 vs. 3.6 ± 1.6) when compared with controls. No difference between AN and BN was found. No correlation between HLS-EU-Q16 Total Score and duration of illness was found. A negative correlation was found between EDE-Q Eating Concerns and subjective HL levels. HLS-EU-Q16 Total Score was predicted by educational level in control subjects only, while NVS Total Score was not predicted by educational level in control subjects nor in patients. CONCLUSION Patients with AN and BN had lower levels of subjective HL. NVS scores could overestimate objective HL in female patients with AN and BN. The promotion of HL in areas differing from those that concern nutritional characteristics of food, could be a therapeutic target for these patients. LEVEL OF EVIDENCE III: Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Chiara Campanino
- Psychiatric Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Andrea Falone
- Psychiatric Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Eleonora Rossi
- Psychiatric Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Emanuele Cassioli
- Psychiatric Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Sara Gemignani
- Psychiatric Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Giulietta Brogioni
- Psychiatric Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Giovanni Castellini
- Psychiatric Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | | | | | - Valdo Ricca
- Psychiatric Unit, Department of Health Sciences, University of Florence, Florence, Italy
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Casale S, Fioravanti G, Bocci Benucci S, Falone A, Ricca V, Rotella F. A meta-analysis on the association between self-esteem and problematic smartphone use. Computers in Human Behavior 2022. [DOI: 10.1016/j.chb.2022.107302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Fioravanti G, Casale S, Benucci SB, Prostamo A, Falone A, Ricca V, Rotella F. Fear of missing out and social networking sites use and abuse: A meta-analysis. Computers in Human Behavior 2021. [DOI: 10.1016/j.chb.2021.106839] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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