BACKGROUND Sleep dysfunction is a common problem in people with schizophrenia,and side effects of treatment often exacerbate metabolic and cardiovascular risk and may induce extrapyramidal side effects.Melatonin(N-ace...BACKGROUND Sleep dysfunction is a common problem in people with schizophrenia,and side effects of treatment often exacerbate metabolic and cardiovascular risk and may induce extrapyramidal side effects.Melatonin(N-acetyl-5-methoxytryptamine)is an endogenously produced hormone which has demonstrated direct and indirect antioxidant and neuroprotective effects.Previous studies have explored the use of exogenous melatonin in improving sleep outcomes in the general population,yet indications for use in schizophrenia are unclear.AIM To synthesize the evidence from clinical trials investigating prescribed melatonin as an adjunctive therapy in patients with schizophrenia.METHODS A systematic literature review of MEDLINE(Ovid),Embase,PsychINFO,and PubMed on the 27/08/20;and CINAHL and Cochrane Library databases,was conducted.Inclusion criteria were:a peer-reviewed clinical trial published in English;included a group of patients with schizophrenia;used melatonin as an adjunctive therapy;and reported any outcome of any duration.Exclusion criteria were:neurodegenerative diseases,primary sleep disorders,co-morbid substance use or animal studies.RESULTS Fifteen studies were included in the current review with the following primary outcomes:sleep(n=6),metabolic profile(n=3),tardive dyskinesia(n=3),cognitive function(n=2)and benzodiazepine discontinuation(n=1).CONCLUSION Adjunctive melatonin therapy has some positive outcomes for sleep,metabolic profile and tardive dyskinesia in patients with schizophrenia.No beneficial effect of melatonin was observed on outcomes of cognition or benzodiazepine discontinuation.Future studies utilizing larger samples and investigations specifically comparing the effect of melatonin as adjunctive therapy with different antipsychotics in patients with schizophrenia are required.展开更多
Mental illness is recognized as a significant social and public health problem in China, with approximately 16 million people affected with mental illness according to a report in 2002.^1 In addition, approximately 30...Mental illness is recognized as a significant social and public health problem in China, with approximately 16 million people affected with mental illness according to a report in 2002.^1 In addition, approximately 30 million children and young adolescents are suffering from mood and/or behavioral disorders. Drug and alcohol problems and other psychosocial disorders affecting women, elders and survivors of disasters are also important problems adding to the overall national mental health burden. Research from both China and abroad indicate that mental and behavioral problems will continue to increase in the future. The World Health Organization （WHO） has warned that the financial burden from mental disorders in China will constitute 1/4 of total burden from various diseases in 2020.^1展开更多
Global biodiversity is in crises.Recognition of the scale and pace of biodiversity loss is leading to rapid technological development in biodiversity science to identify species,their interactions,and eco-system dynam...Global biodiversity is in crises.Recognition of the scale and pace of biodiversity loss is leading to rapid technological development in biodiversity science to identify species,their interactions,and eco-system dynamics.National and international policy developments to stimulate mitigation and remediation actions are escalating to meet the biodiversity crises.They can take advantage of biosurveil-lance“big data”as evidence for more sweeping and impactful policy measures.The critical factor is translating biosurveillance data into the value-based frameworks underpinning new policy measures.An approach to this integration process,using natural capital accounting frameworks is developed.展开更多
文摘BACKGROUND Sleep dysfunction is a common problem in people with schizophrenia,and side effects of treatment often exacerbate metabolic and cardiovascular risk and may induce extrapyramidal side effects.Melatonin(N-acetyl-5-methoxytryptamine)is an endogenously produced hormone which has demonstrated direct and indirect antioxidant and neuroprotective effects.Previous studies have explored the use of exogenous melatonin in improving sleep outcomes in the general population,yet indications for use in schizophrenia are unclear.AIM To synthesize the evidence from clinical trials investigating prescribed melatonin as an adjunctive therapy in patients with schizophrenia.METHODS A systematic literature review of MEDLINE(Ovid),Embase,PsychINFO,and PubMed on the 27/08/20;and CINAHL and Cochrane Library databases,was conducted.Inclusion criteria were:a peer-reviewed clinical trial published in English;included a group of patients with schizophrenia;used melatonin as an adjunctive therapy;and reported any outcome of any duration.Exclusion criteria were:neurodegenerative diseases,primary sleep disorders,co-morbid substance use or animal studies.RESULTS Fifteen studies were included in the current review with the following primary outcomes:sleep(n=6),metabolic profile(n=3),tardive dyskinesia(n=3),cognitive function(n=2)and benzodiazepine discontinuation(n=1).CONCLUSION Adjunctive melatonin therapy has some positive outcomes for sleep,metabolic profile and tardive dyskinesia in patients with schizophrenia.No beneficial effect of melatonin was observed on outcomes of cognition or benzodiazepine discontinuation.Future studies utilizing larger samples and investigations specifically comparing the effect of melatonin as adjunctive therapy with different antipsychotics in patients with schizophrenia are required.
文摘Mental illness is recognized as a significant social and public health problem in China, with approximately 16 million people affected with mental illness according to a report in 2002.^1 In addition, approximately 30 million children and young adolescents are suffering from mood and/or behavioral disorders. Drug and alcohol problems and other psychosocial disorders affecting women, elders and survivors of disasters are also important problems adding to the overall national mental health burden. Research from both China and abroad indicate that mental and behavioral problems will continue to increase in the future. The World Health Organization （WHO） has warned that the financial burden from mental disorders in China will constitute 1/4 of total burden from various diseases in 2020.^1
文摘Global biodiversity is in crises.Recognition of the scale and pace of biodiversity loss is leading to rapid technological development in biodiversity science to identify species,their interactions,and eco-system dynamics.National and international policy developments to stimulate mitigation and remediation actions are escalating to meet the biodiversity crises.They can take advantage of biosurveil-lance“big data”as evidence for more sweeping and impactful policy measures.The critical factor is translating biosurveillance data into the value-based frameworks underpinning new policy measures.An approach to this integration process,using natural capital accounting frameworks is developed.
