Sex differences in neurocognitive abilities have been extensively explored both in the healthy population andin many disorders. Until recently, however, little work has examined such differences in people with Alzheim...Sex differences in neurocognitive abilities have been extensively explored both in the healthy population andin many disorders. Until recently, however, little work has examined such differences in people with Alzheimer's disease(AD). This is despite clear evidence that AD is more prevalent in women, and converging lines of evidence from brain imaging, post-mortem analyses, hormone therapy and genetics suggesting that AD affects men and women differently. We provide an overview of evidence attesting to the poorer cognitive profiles in women than in men at the same stage of AD. Indeed, men significantly outperform women in several cognitive domains, including: Language and semantic abilities, visuospatial abilities and episodic memory. These differences do not appear to be attributable to any differences in age, education, or dementia severity. Reasons posited for this female disadvantage include a reduction of estrogen in postmenopausal women, greater cognitive reserve in men, and the influence of the apolipoprotein E ε4 allele. Assessment of cognitive abilities contributes to the diagnosis of the condition and thus, it is crucial to identify the role of sex differences if potentially more accurate diagnoses and treatments are to emerge.展开更多
BACKGROUND Art therapies are advocated by national bodies,such as the United Kingdom’s National Institute for Health and Care Excellence,to alleviate the negative symptoms associated with schizophrenia.The last decad...BACKGROUND Art therapies are advocated by national bodies,such as the United Kingdom’s National Institute for Health and Care Excellence,to alleviate the negative symptoms associated with schizophrenia.The last decade has however,seen several new larger well-controlled trials published suggesting an update is timely.AIM To asses randomised controlled trials(RCT)of art therapies for reducing the symptoms of schizophrenia–particularly negative symptoms.METHODS Searches of PubMed and Scopus were conducted until May 2019 for RCTs examining the impact of art therapies on psychosis(positive,negative and total)symptoms in people diagnosed with schizophrenia.Study quality was assessed using the Cochrane risk of bias tool.Random effects meta-analyses were used to derive overall effect sizes.Moderator analyses were conducted using both metaregression and categorical comparisons.RESULTS We identified 133 articles,of which 9 RCTs involving 948 participants(475 assigned to art therapies and 473 controls)met our inclusion criteria.Using random effects models,we calculated pooled effect sizes(Hedges g)for end-oftrial symptomatic outcomes.Effect sizes both for total symptoms[g=-0.27,95%confidence interval(CI)-0.60 to 0.05,k=6]and for positive symptoms(g=-0.10,95%CI-0.35 to 0.15,k=6)were non-significant;however,we did find significant reduction of negative symptoms(g=-0.42,95%CI-0.70 to-0.14,k=9).Metaregression revealed that negative symptom reduction was larger in trials with a greater proportion of women and in trials with younger patients.Crucially,the negative symptom reduction following art therapies was limited to lower quality trials and did not emerge in trials that used blind assessment of outcomes.CONCLUSION This review presents a comprehensive meta-analysis of art therapies in schizophrenia in terms of both studies included and participant numbers.We found that art therapies did not significantly reduce total or positive symptoms.A"small"therapeutic effect was found for negative symptoms,but we show that the effect is not present in blind trials and may be subject to publication bias.展开更多
文摘Sex differences in neurocognitive abilities have been extensively explored both in the healthy population andin many disorders. Until recently, however, little work has examined such differences in people with Alzheimer's disease(AD). This is despite clear evidence that AD is more prevalent in women, and converging lines of evidence from brain imaging, post-mortem analyses, hormone therapy and genetics suggesting that AD affects men and women differently. We provide an overview of evidence attesting to the poorer cognitive profiles in women than in men at the same stage of AD. Indeed, men significantly outperform women in several cognitive domains, including: Language and semantic abilities, visuospatial abilities and episodic memory. These differences do not appear to be attributable to any differences in age, education, or dementia severity. Reasons posited for this female disadvantage include a reduction of estrogen in postmenopausal women, greater cognitive reserve in men, and the influence of the apolipoprotein E ε4 allele. Assessment of cognitive abilities contributes to the diagnosis of the condition and thus, it is crucial to identify the role of sex differences if potentially more accurate diagnoses and treatments are to emerge.
文摘BACKGROUND Art therapies are advocated by national bodies,such as the United Kingdom’s National Institute for Health and Care Excellence,to alleviate the negative symptoms associated with schizophrenia.The last decade has however,seen several new larger well-controlled trials published suggesting an update is timely.AIM To asses randomised controlled trials(RCT)of art therapies for reducing the symptoms of schizophrenia–particularly negative symptoms.METHODS Searches of PubMed and Scopus were conducted until May 2019 for RCTs examining the impact of art therapies on psychosis(positive,negative and total)symptoms in people diagnosed with schizophrenia.Study quality was assessed using the Cochrane risk of bias tool.Random effects meta-analyses were used to derive overall effect sizes.Moderator analyses were conducted using both metaregression and categorical comparisons.RESULTS We identified 133 articles,of which 9 RCTs involving 948 participants(475 assigned to art therapies and 473 controls)met our inclusion criteria.Using random effects models,we calculated pooled effect sizes(Hedges g)for end-oftrial symptomatic outcomes.Effect sizes both for total symptoms[g=-0.27,95%confidence interval(CI)-0.60 to 0.05,k=6]and for positive symptoms(g=-0.10,95%CI-0.35 to 0.15,k=6)were non-significant;however,we did find significant reduction of negative symptoms(g=-0.42,95%CI-0.70 to-0.14,k=9).Metaregression revealed that negative symptom reduction was larger in trials with a greater proportion of women and in trials with younger patients.Crucially,the negative symptom reduction following art therapies was limited to lower quality trials and did not emerge in trials that used blind assessment of outcomes.CONCLUSION This review presents a comprehensive meta-analysis of art therapies in schizophrenia in terms of both studies included and participant numbers.We found that art therapies did not significantly reduce total or positive symptoms.A"small"therapeutic effect was found for negative symptoms,but we show that the effect is not present in blind trials and may be subject to publication bias.
