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1.
Efficacy of omega-3 supplementation on sertraline continuous therapy to reduce depression or anxiety symptoms: A systematic review and meta-analysis.
Chambergo-Michilot, D, Brañez-Condorena, A, Falvy-Bockos, I, Pacheco-Mendoza, J, Benites-Zapata, VA
Psychiatry research. 2021;:113652
Abstract
We aimed to synthesize the evidence from randomized controlled trials (RCTs) that determined the efficacy of adding omega-3 supplementation to the continuous sertraline therapy in adults with depression. Meta-analyses were performed using random effects. We used the Revised Cochrane risk of bias tool for randomized trials version 2.0. to assess the risk of bias. Four RCTs were included. The follow-up ranged from eight to 12 weeks. Regarding the Beck Depression Inventory, the pooled SMD was 0.50 (95% CI: -0.51, 1.50; I2: 94.1%). A subgroup analysis was performed regarding the presence of coronary disease: SMD -0.17 (95% CI: -0.41, 0.07; I2: 0.0%). Regarding the Beck Anxiety Inventory, the pooled MD was 0.03 (95% CI: -2.22, 2.28; I2: 0.0%). Regarding the Hamilton Depression Rating Scale, the pooled MD was 0.42 (95% CI: -1.44, 2.29; I2: 35.7%). All pooled outcomes presented a very low certainty of the evidence. Three RCTs presented a low risk of bias in all domains; however, one study presented some concerns in two domains. No essential reductions in the outcomes were found. A subgroup analysis suggested that may be better not to provide the supplementation in patients with coronary disease. The evidence is not enough to make recommendations.
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2.
Fasting Interventions for Stress, Anxiety and Depressive Symptoms: A Systematic Review and Meta-Analysis.
Berthelot, E, Etchecopar-Etchart, D, Thellier, D, Lancon, C, Boyer, L, Fond, G
Nutrients. 2021;(11)
Abstract
BACKGROUND Fasting interventions have shown effectiveness in alleviating stress, anxiety and depressive symptoms. However, no quantitative analysis has been carried out thus far. The objective was to determine the effectiveness of fasting interventions on stress, anxiety and depression and if these interventions were associated with increased or decreased fatigue/energy. METHODS Overall, 11 studies and 1436 participants were included in the quantitative analyses. RESULTS After limiting analyses to randomized controlled trials with low risk of bias, we found that fasting groups had lower anxiety (b = -0.508, p = 0.038), depression levels (b= -0.281, p = 0.012) and body mass index compared to controls without increased fatigue. There was no publication bias and no heterogeneity for these results. These interventions were safe, even in patients with type 2 diabetes. CONCLUSIONS These results should be taken with a caveat. These results are preliminary and encouraging and fasting appears to be a safe intervention. Data are not sufficient to recommend one fasting intervention more than the others. No study was carried out in psychiatric populations and further trials should be carried out in these populations that may be good candidates for fasting interventions.
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3.
[Prevalence of anxiety among health professionals in times of COVID-19: a systematic review with meta-analysis].
Silva, DFO, Cobucci, RN, Soares-Rachetti, VP, Lima, SCVC, Andrade, FB
Ciencia & saude coletiva. 2021;(2):693-710
Abstract
This study sets out to identify the prevalence of anxiety among health professionals during the COVID-19 pandemic. It involves a systematic review and meta-analysis of studies published in any language in 2020. A search was conducted in the Embase, LILACS and PubMed databases using the keywords anxiety, COVID-19, health workers, and synonyms. The estimated overall prevalence of anxiety with a 95% confidence interval was calculated using the random effects model. Of the 861 records identified, 36 articles were included in the systematic review and 35 in the meta-analysis. The overall prevalence of anxiety was 35% (95%CI: 29-40). A higher risk of anxiety was identified among women compared to men (Odds Ratio: 1.64 [95%CI: 1.47-1.84]), and in nurses, in comparison with physicians (Odds Ratio: 1.19 [95%CI: 1.07-1.33]). Being on the front line of COVID-19, being infected with coronavirus and having chronic diseases were also factors associated with a higher risk of anxiety. A high prevalence of anxiety among health professionals was observed, with higher risk among women and nurses. There is a pressing need for measures aimed at prevention of anxiety and providing early and appropriate treatment for those suffering from moderate and severe anxiety.
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4.
Effects and moderators of coping skills training on symptoms of depression and anxiety in patients with cancer: Aggregate data and individual patient data meta-analyses.
Buffart, LM, Schreurs, MAC, Abrahams, HJG, Kalter, J, Aaronson, NK, Jacobsen, PB, Newton, RU, Courneya, KS, Armes, J, Arving, C, et al
Clinical psychology review. 2020;:101882
Abstract
PURPOSE This study evaluated the effects of coping skills training (CST) on symptoms of depression and anxiety in cancer patients, and investigated moderators of the effects. METHODS Overall effects and intervention-related moderators were studied in meta-analyses of pooled aggregate data from 38 randomized controlled trials (RCTs). Patient-related moderators were examined using linear mixed-effect models with interaction tests on pooled individual patient data (n = 1953) from 15 of the RCTs. RESULTS CST had a statistically significant but small effect on depression (g = -0.31,95% confidence interval (CI) = -0.40;-0.22) and anxiety (g = -0.32,95%CI = -0.41;-0.24) symptoms. Effects on depression symptoms were significantly larger for interventions delivered face-to-face (p = .003), led by a psychologist (p = .02) and targeted to patients with psychological distress (p = .002). Significantly larger reductions in anxiety symptoms were found in younger patients (pinteraction < 0.025), with the largest reductions in patients <50 years (β = -0.31,95%CI = -0.44;-0.18) and no significant effects in patients ≥70 years. Effects of CST on depression (β = -0.16,95%CI = -0.25;-0.07) and anxiety (β = -0.24,95%CI = -0.33;-0.14) symptoms were significant in patients who received chemotherapy but not in patients who did not (pinteraction < 0.05). CONCLUSIONS CST significantly reduced symptoms of depression and anxiety in cancer patients, and particularly when delivered face-to-face, provided by a psychologist, targeted to patients with psychological distress, and given to patients who were younger and received chemotherapy.
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5.
The effects of saffron (Crocus sativus L.) on mental health parameters and C-reactive protein: A meta-analysis of randomized clinical trials.
Ghaderi, A, Asbaghi, O, Reiner, Ž, Kolahdooz, F, Amirani, E, Mirzaei, H, Banafshe, HR, Maleki Dana, P, Asemi, Z
Complementary therapies in medicine. 2020;:102250
Abstract
BACKGROUND The findings of trials investigating the effects of saffron (Crocus sativus L.) supplementation on depression, anxiety, and C-reactive protein (CRP) are inconsistent. The current meta-analysis of randomized controlled trials (RCTs) was carried out to assess the effects of saffron (Crocus sativus L.) administration on mental health parameters and CRP levels. METHODS Two independent authors systematically searched online databases including EMBASE, Scopus, PubMed, Cochrane Library, and Web of Science from inception until 30th July 2019. Cochrane Collaboration risk of bias tool was applied to assess the methodological quality of included trials. The heterogeneity among the included studies was assessed using Cochrane's Q test and I-square (I2) statistic. Data were pooled using a random-effects model and weighted mean difference (WMD) was considered as the overall effect size. RESULTS Twenty one trials were included in this meta-analysis. Consumption of saffron resulted in a significant reduction in Beck Depression Inventory (BDI) (11 studies with 12 effect size) (WMD: -4.86; 95 % CI: -6.58, -3.14), Beck Anxiety Inventory (BAI) (5 studies) (WMD: -5.29; 95 % CI: -8.27, -2.31) and Pittsburgh Sleep Quality Index (PSQI) scores (3 studies with 4 effect size) (WMD: -2.22; 95 % CI: -2.73, -1.72). Saffron intake did not affect Hamilton Depression Rating Scale (HDRS-D), Hamilton Anxiety Rating Scale (HARS-A) scores and C-reactive protein (CRP) levels. CONCLUSIONS This meta-analysis demonstrated that saffron intake significantly reduced BDI, BAI and PSQI scores, but did not affect HDRS-D, HARS-A scores and CRP levels.
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6.
The best route of administration of lavender for anxiety: a systematic review and network meta-analysis.
Sayed, AM, Morsy, S, Tawfik, GM, Naveed, S, Minh-Duc, NT, Hieu, TH, Ali, ZA, Shinkar, A, Doheim, MF, Hashan, MR, et al
General hospital psychiatry. 2020;:33-40
Abstract
BACKGROUND There is preliminary evidence for lavender as an anxiolytic agent through various routes of administration. Our goal is to elucidate the best route of administration for lavender as a treatment for anxiety. METHODS Thirteen electronic search engines were systematically scanned for relevant publications. The relevant articles were included after the title and abstract screening followed by the full-text screening. This study included randomized control trials reporting lavender for the treatment of anxiety. The protocol was registered in PROSPERO (CRD42017076711). Frequentist network meta-analysis and Bayesian meta-regression were conducted to report the best treatment modality and the effect of covariates on the effectiveness as an anxiolytic. Treatment arms were ordered according P-scores, where higher P-score indicates better treatment choice. RESULTS Forty studies were eligible for qualitative analysis, and 32 were included in quantitative analysis. Lavender aromatherapy was the best approach for the treatment of anxiety among other lavender modalities at the first week recording [Standardized Mean Difference (SMD) = -0.57, 95% CI (-1.14-0.01), P-score = 0.72], in addition to achieve at the first time points [SMD = -0, 95% CI (-0.97 ̶ -0.16), P-score = 0.69], compared to placebo; however, lavender massage along with foot bath were found to be the most efficacious for anxiety treatment at the study endpoint [SMD = -1.10, 95% CI = (-7.41 ̶ 5.21), P-score = 0.65]. Furthermore, network meta-regression revealed that the duration of therapy influenced treatment, suggesting Silexan (oral lavender) 80 mg (first rank probability = .116) as the favorable option for anxiety in long-term treatment. CONCLUSIONS Lavender aromatherapy is, clinically, superior in short-duration, while Silexan (oral lavender) 80 mg is preferable for long-term treatment of anxiety.
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7.
The effect of a very low calorie diet on subjective depressive symptoms and anxiety: meta-analysis and systematic review.
Ein, N, Armstrong, B, Vickers, K
International journal of obesity (2005). 2019;(7):1444-1455
Abstract
There are conflicting findings regarding the effect very low calorie diets (VLCDs) have on self-reported depressive symptoms and anxiety levels. Some studies have reported decreased subjective depressive symptoms and anxiety post-diet, whereas other studies have not. Further complicating matters, the protocol for VLCDs vary substantially across studies, which could account for the mixed findings. The primary goal of this meta-analysis and systematic review was to determine the effect VLCDs have on subjective depressive symptoms and anxiety pre- to post-diet. In addition, potential moderators (the presence/absence of behavioral therapy, duration of diet, inclusion/exclusion of low intensity exercise, and amount of weight lost) were examined to assess the effect of procedural deviations across VLCD studies on depressive symptoms and anxiety. A random-effects model was used for the meta-analysis and included nine studies with 16 independent samples. To further explain the results, study rigor was examined in the systematic review, which included 11 studies with 20 independent samples. Depressive symptoms significantly decreased pre- to post-diet when behavioral therapy was implemented during the diet, the duration of the diet was relatively long (8-16 weeks), low intensity exercise was included, and the dieters lost 14.1 kg or more post-diet. However, no difference in depressive symptoms were observed pre- to post-diet when behavioral therapy was not included, the diet was shorter (1-7 weeks), no exercise was implemented and dieters lost <14 kg of weight post-diet. There was no change in anxiety pre- to post-diet. Health care providers involved in supervising VLCDs should consider using a VLCD of at least 8 weeks that includes behavioral therapy and low intensity exercise in order to enhance the potential benefits of VLCDs on depressive symptoms. More research is required to examine the effect of VLCDs on anxiety.
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8.
Herbal medicine for post-stroke anxiety: A systematic review and meta-analysis of randomized controlled trials.
Kwon, CY, Lee, B, Chung, SY, Kim, JW
Complementary therapies in clinical practice. 2019;:237-252
Abstract
The study was conducted to investigate the efficacy and safety of herbal medicine (HM) for post-stroke anxiety (PSA). Through comprehensive searches, twenty randomized controlled trials were included. Meta-analysis showed that compared to the HM group, the conventional pharmacotherapy group showed significantly lower Hamilton anxiety rating scale (HAMA) score after 1 week of treatment, but not after 2, 4, and 6 weeks of treatment, and higher HAMA score after 8 weeks and 3 months of treatment. Meanwhile, compared to the conventional pharmacotherapy alone group, the HM plus conventional pharmacotherapy group showed significantly better results in HAMA score after 2, 4, 6, and 8 weeks of treatment. HM group was associated with lower incidence of adverse events. Current evidence suggests that HM or HM plus conventional pharmacotherapy may be safe and effective in PSA patients within a certain time period. However, due to limited strength of evidence, definite conclusions are not possible.
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9.
The efficacy of herbal medicines on anxiety and depression in peri- and postmenopausal women: A systematic review and meta-analysis.
Shahmohammadi, A, Ramezanpour, N, Mahdavi Siuki, M, Dizavandi, F, Ghazanfarpour, M, Rahmani, Y, Tahajjodi, R, Babakhanian, M
Post reproductive health. 2019;(3):131-141
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10.
Efficacy of probiotics on anxiety-A meta-analysis of randomized controlled trials.
Liu, B, He, Y, Wang, M, Liu, J, Ju, Y, Zhang, Y, Liu, T, Li, L, Li, Q
Depression and anxiety. 2018;(10):935-945
Abstract
BACKGROUND The concept "psychobiotics" claims potential beneficial effect of probiotics on anxiety, whereas findings from clinical trials are inconsistent. Thus, a meta-analysis is needed to clarify the effect of probiotics on anxiety. METHODS Randomized controlled trials (RCTs) assessing the effect of probiotics on anxiety were systematically retrieved from online databases and manually screened for references of relevant published literature through September 1, 2017. Standardized mean difference in change from baseline of anxiety rating scales between probiotics groups and placebo groups was selected as the main effect index. Subgroup analyses were conducted with respect to overall health status of the sample, existence of gastrointestinal symptoms, strains of flora, trial duration, and risk of bias assessment. Publication bias was evaluated by funnel plot and Egger's test. The reliability of the result was assessed by leave-one-out sensitivity analysis. RESULTS Twelve studies with 1,551 subjects (871 in probiotics group and 680 in control group) were included. All the studies were rated as low or moderate risk of bias. The meta-analysis and subgroup analyses all showed no significant difference between probiotics and placebo in alleviating anxiety symptoms. The Egger's test revealed no evidence of significant publication bias. Sensitivity analysis showed that leaving out one study would result in marginal significance. CONCLUSIONS The evidence for the efficacy of probiotics in alleviating anxiety, as presented in currently published RCTs, is insufficient. More reliable evidence from clinical trials is needed before a case can be made for promoting the use of probiotics for alleviating anxiety.