1
|
Weiser M, Levi L, Park J, Nastas I, Matei V, Davidson M, Arad I, Dudkiewicz I, Davis JM. A randomized controlled trial of add-on naproxen, simvastatin and their combination for the treatment of schizophrenia or schizoaffective disorder. Eur Neuropsychopharmacol 2023; 73:65-74. [PMID: 37126871 DOI: 10.1016/j.euroneuro.2023.04.007] [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: 01/04/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 05/03/2023]
Abstract
This large randomized controlled trial examined the effect of naproxen, simvastatin or both on patients with schizophrenia. This was a large multi-center, twelve-week, randomized, double-blind, placebo-controlled, four-arm clinical trial administering naproxen, simvastatin or both to 232 subjects with schizophrenia or schizoaffective disorder. The primary outcome was change in PANSS total score. ANCOVA and mixed model analyses of the PANSS total score change showed no significant difference between naproxen and placebo (adjusted p = 0.78), simvastatin and placebo (adjusted p = 0.38) or the combination of naproxen and simvastatin compared to placebo (adjusted p = 0.72). No statistically significant drug-placebo differences were found in the PANSS subscales, CGI or BACS between all groups. There was a near significant improvement in negative symptoms (p = 0.06), and an analysis of the 5 factor PANSS factors analysis found a significant improvement in simvastatin above placebo in withdrawal (p = 0.03). These finding were not significant after correcting for multiple comparisons. A meta-analysis on changes in total PANSS scores in studies on statins in schizophrenia, including the present study together with six other studies showed a significant improvement for statins compared to placebo (Hedges' G of -0.245 (CI= -0.403, -0.086, p = 0.002). When one outlying study which showed particularly strong effects of statins was removed, part of the effect went away. In conclusion, in this study, naproxen and simvastatin alone or in combination were not efficacious in the treatment of symptoms in schizophrenia. However, the meta-analysis of all studies of simvastatin for schizophrenia indicates further research on this topic.
Collapse
Affiliation(s)
- Mark Weiser
- Sheba Medical Center, Tel Hashomer 52621, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Linda Levi
- Sheba Medical Center, Tel Hashomer 52621, Israel
| | - Jinyoung Park
- Department of Psychology and Neuroscience, Duke University, USA
| | - Igor Nastas
- Department of Psychiatry, Narcology and Medical Psychology, State University of Medicine and Pharmacy Nicolae Testemitanu, Chișinău, Moldova
| | - Valentin Matei
- Department of Neuroscience, discipline of Psychiatry, University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
| | | | - Ido Arad
- Sheba Medical Center, Tel Hashomer 52621, Israel
| | - Israel Dudkiewicz
- Sheba Medical Center, Tel Hashomer 52621, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - John M Davis
- Department of Psychiatry, University of Illinois, Chicago, IL 60607, USA
| |
Collapse
|
2
|
Conceição V, Rothes I, Gusmão R. The effects of a video-based randomized controlled trial intervention on depression stigma and help-seeking attitudes in university students. Psychiatry Res 2022; 308:114356. [PMID: 34972028 DOI: 10.1016/j.psychres.2021.114356] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/10/2021] [Accepted: 12/19/2021] [Indexed: 12/20/2022]
Abstract
University students are a risk group for developing mental illness, but they do not receive the care they need because of hampered help-seeking induced by stigma. This study evaluates the effects of a video-based stigma reduction intervention and help-seeking attitudes promotion in university students. We randomly distributed a sample of university students among one control group (CG, n = 188) and two intervention groups (IG-1, n = 222 and IG-2, n = 216): IG-1 watched a contact-based video and IG-2 the same video plus a psychoeducational video. The study followed an experimental single-blind randomized control trial design with a pre-test before the intervention (M0), a post-test, and a follow-up test. We evaluated participants using a sociodemographic questionnaire, the Attitudes Toward Seeking Professional Psychological Help Questionnaire, the Depression Stigma Scale, the 9-item Patient Health Questionnaire, and the 7-item Generalized Anxiety Disorder. A total of 626 participants with a mean age of 19.85 (SD=1.48) responded to all evaluation moments. At M0, there were no differences between groups on stigma or help-seeking attitudes. Immediately after the intervention, stigma levels significantly decreased, and help-seeking attitudes significantly improved. These effects persisted for the next five months. Video-based depression stigma reduction intervention can be an essential tool to reduce depression stigma and improve help-seeking attitudes.
Collapse
Affiliation(s)
- Virgínia Conceição
- EPIUnit - Institute of Public Health, University of Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
| | - Inês Rothes
- Faculty of Psychology and Education Science, University of Porto, Portugal; Centre for Psychology, University of Porto, Portugal
| | - Ricardo Gusmão
- EPIUnit - Institute of Public Health, University of Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Portugal
| |
Collapse
|
3
|
Sand K, Guldal AU, Myklebust TÅ, Hoff DAL, Juvkam PC, Hole T. Cardiopulmonary resuscitation retention training for hospital nurses by a self-learner skill station or the traditional instructor led course: A randomised controlled trial. Resusc Plus 2021; 7:100157. [PMID: 34467255 PMCID: PMC8384897 DOI: 10.1016/j.resplu.2021.100157] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/01/2021] [Accepted: 08/01/2021] [Indexed: 10/26/2022] Open
Abstract
Introduction Intrahospital cardiac arrest has a steep mortality and high-quality cardiopulmonary resuscitation (CPR) is essential for favourable outcome. Instructor led (IL) CPR training is resource demanding and instructor free, feedback providing CPR skill stations (SS) could provide a means to enable the needed frequent retraining. The main objective of this study was to test the hypothesis that there was no difference between IL and SS training. Methods A total of 129 hospital nurses were randomised to CPR retraining in three groups; skill station with retraining at 2 months (SS-R), skill station without retraining (SS) and instructor led training (IL). Participants were tested at baseline, 2 and 8 months. The skill station groups were combined (c-SS) for analysis at baseline and 2 months when comparing to IL. Results Baseline characteristics for the three groups differed significantly, however c-SS and IL groups performed equally at baseline and testing at 2 months. At 8 months the SS group performed 71% correct ventilations compared to 54% in the IL group (p = 0.04), but CPR quality was otherwise equal. Longitudinal analysis showed SS-R performed 3.4 mm deeper compressions at final evaluation compared to baseline (p = 0.02) and 2.8 mm deeper compared to 2-month test (p = 0.02). No effects of retraining at 2 months could be detected at final comparison of SS-R and SS groups. Conclusion CPR training using a skill station led to equal performance at 2 and 8 months compared to instructor led training. Feedback-providing skill stations could be a feasible tool for required frequent retraining.
Collapse
Affiliation(s)
- Kristoffer Sand
- Department of Medicine, Ålesund Hospital, Møre & Romsdal Hospital Trust, Ålesund, Norway.,Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway.,Department of Research and Innovation, Møre & Romsdal Hospital Trust, Ålesund, Norway
| | | | - Tor Åge Myklebust
- Department of Research and Innovation, Møre & Romsdal Hospital Trust, Ålesund, Norway
| | - Dag Arne Lihaug Hoff
- Department of Medicine, Ålesund Hospital, Møre & Romsdal Hospital Trust, Ålesund, Norway.,Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway.,Department of Research and Innovation, Møre & Romsdal Hospital Trust, Ålesund, Norway
| | - Per Christian Juvkam
- Clinic of Emergency Medicine and Prehospital Care, St. Olav's University Hospital, Trondheim, Norway
| | - Torstein Hole
- Department of Medicine, Ålesund Hospital, Møre & Romsdal Hospital Trust, Ålesund, Norway.,Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway
| |
Collapse
|
4
|
Elfrink TR, Zuidema SU, Kunz M, Westerhof GJ. The effectiveness of creating an online life story book on persons with early dementia and their informal caregivers: a protocol of a randomized controlled trial. BMC Geriatr 2017; 17:95. [PMID: 28431515 PMCID: PMC5399324 DOI: 10.1186/s12877-017-0471-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 03/31/2017] [Indexed: 11/18/2022] Open
Abstract
Background Dementia has a high burden for patients, informal caregivers and society. Given changes in care systems, more persons with dementia will live longer at home. However, living at home (with dementia) with a good quality of life is not easy to achieve. Dementia is often accompanied by neuropsychiatric symptoms like apathy, agitation, depression, and anxiety, which have a negative impact on quality of life. Whereas cognitive deterioration can hardly be influenced, it is possible to reduce neuropsychiatric symptoms. As autobiographical memories remain intact for a relatively long time in dementia, reminiscence interventions can promote feelings of pleasure and trust. The Online Life Story Book (OLSB) allows to digitally share memories (stories, pictures, video or audio fragments). The main objective is to study the effects of the OLSB on neuropsychiatric symptoms. The study has four secondary objectives: 1) to study the effectiveness of the intervention on the burden and quality of life of the primary informal caregiver; 2) to provide a preliminary health-economic evaluation; 3) to study the (time to) nursing home admittance as a longer term effect; 4) to provide a process evaluation. Methods and design A randomized controlled trial with individual randomization to one of two conditions is conducted: 1) intervention “Online Life Story Book”; 2) control condition (care as usual). Participants are persons with early dementia and their primary caregivers. In the intervention OLSB, a trained volunteer guides the participants through the process of putting together a timeline of their lives during 5 meetings within a period of 8-10 weeks. To assess the effects of the intervention on the primary outcome, neuropsychiatric symptoms, the Neuropsychiatric Inventory (NPI) will be assessed at three time points: before the intervention (baseline, T0), 3 months (T1) and 6 months (T2) post baseline. Discussion When proven effective, the Online Life Story Book can be a valuable addition to the existing provision of care for persons with dementia and their informal caregivers. Trial registration This study has been approved by the Twente Medical Ethics Committee under the file number p16-04 (Dutch Trial Register: NTR5939, date of registration: 14 March 2016).
Collapse
Affiliation(s)
- Teuntje R Elfrink
- Department of Psychology, Health and Technology, University of Twente, P.O. Box 217, 7500, AE, Enschede, The Netherlands.
| | - Sytse U Zuidema
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700, RB, Groningen, The Netherlands
| | - Miriam Kunz
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700, RB, Groningen, The Netherlands
| | - Gerben J Westerhof
- Department of Psychology, Health and Technology, University of Twente, P.O. Box 217, 7500, AE, Enschede, The Netherlands
| |
Collapse
|
5
|
Østerås H, Paulsberg F, Olsen SE, Østerås B, Torstensen TA. Effects of medical exercise therapy in patients with hip osteoarthritis: A randomized controlled trial with six months follow-up. A pilot study. J Bodyw Mov Ther 2016; 21:284-289. [PMID: 28532870 DOI: 10.1016/j.jbmt.2016.06.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 06/24/2016] [Accepted: 06/28/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND & AIMS There is no consensus regarding what type of exercises, combination of exercises or exercise dosage is most effective in patients with long-term hip arthrosis. The goal of this study was to evaluate the effects of two different exercise programs related to dose-response relationships. METHOD Prospective randomized controlled clinical trial with 6 months follow where 33 participants were randomly assigned to either high repetitive, high dosage medical exercise therapy (MET) (n = 16) or low dosage exercise therapy (ET) (n = 17). Primary outcomes are pain using a visual analog scale (VAS) and function using a functional assessment questionnaire (WOMAC). RESULTS Patients were equal at baseline. Two patients (6%) dropped out during the treatment period. There were no difference between groups after end of treatment nor at 6 months follow up. However, there were significant differences within each exercise group at end of treatment. CONCLUSION In this pilot study, we were not able to show any difference between MET and ET. More research is needed with a larger patient population and a more extensive exercise period similar to other studies that are published regarding dose-response effects. Clinicaltrials.gov identifier: NCT01700933.
Collapse
Affiliation(s)
- Håvard Østerås
- Norwegian University of Science and Technology, Faculty of Health and Social Science, Trondheim, Norway.
| | | | | | - Berit Østerås
- Norwegian University of Science and Technology, Faculty of Health and Social Science, Trondheim, Norway
| | - Tom Arild Torstensen
- Holten Institute, Stockholm, Sweden and NVS Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|