Biomedical subjects

M J Tacchi

Publications and source records attributed to M J Tacchi.

4 recordsLinked to original sources

PubMed2007

Acute bipolar mania: a systematic review and meta-analysis of co-therapy vs. monotherapy.

INTRODUCTION: The aim of this meta-analysis was to systematically review the effectiveness of co-therapy compared with monotherapy for people with bipolar mania. METHOD: MEDLINE, Embase, Psychinfo, The Cochrane Library and reference lists of retrieved studies were searched without language restrictions for randomized controlled trials evaluating co-therapy compared with monotherapy for acute bipolar mania. Each trial was assessed for susceptibility to bias. Data on mania outcomes, withdrawals, extrapyramidal symptoms and weight were extracted and pooled effect estimates summarized as relative risks (RR) or differences in mean values (MD) where appropriate. RESULTS: Eight eligible studies were included (1124 participants). Significant reductions in mania (Young Mania Rating Scale, YMRS) scores were shown for haloperidol, olanzapine, risperidone and quetiapine as co-therapy compared with monotherapy with a mood stabilizer. For atypical antipsychotics combined, the pooled difference in mean scores was 4.41 (95% CI: 2.74, 6.07). Significantly more participants on co-therapy met the response criterion (at least 50% reduction in YMRS score), RR 1.53 (1.31, 1.80). With some drugs, co-therapy decreased tolerability compared with monotherapy, and resulted in greater weight gain. There were insufficient data to compare one co-therapy regimen with another. CONCLUSION: The addition of antipsychotic treatment to established mood-stabilizer treatment is more effective than mood-stabilizer treatment alone.

Acute Disease↗

PubMed2005

Identifying and improving non-adherence in bipolar disorders.

OBJECTIVES: To review the definition of non-adherence, its clinical and economic impact and identify its role and impact in clinical practice. METHODS: A selective review of the literature as conducted of articles and literature known to the authors. RESULTS: There is a paucity of studies examining specifically treatment non-adherence and its consequences in bipolar disorder. Few studies have systematically examined ways in which treatment adherence can impact treatment and improve outcome. CONCLUSION: Non-adherence is common in the management of bipolar disorder. Clinicians and Researchers alike need to remain alert and be aware of issues related to non-adherence--in particular suicide. Like other course-modifiers non-adherence has to be considered, sought and addressed, and this is perhaps best done by including psychoeducation in routine clinical care.

Attitude to Health↗

PubMed1997

Acute and one-year outcome of a randomised controlled trial of brief cognitive therapy for major depressive disorder in primary care.

BACKGROUND: The consensus statement on the treatment of depression (Paykel & Priest, 1992) advocates the use of cognitive therapy techniques as an adjunct to medication. METHOD: This paper describes a randomised controlled trial of brief cognitive therapy (BCT) plus 'treatment as usual' versus treatment as usual in the management of 48 patients with major depressive disorder presenting in primary care. RESULTS: At the end of the acute phase, significantly more subjects (P < 0.05) met recovery criteria in the intervention group (n = 15) compared with the control group (n = 8). When initial neuroticism scores were controlled for, reductions in Beck Depression Inventory and Hamilton Rating Scale for Depression scores favoured the BCT group throughout the 12 months of follow-up. CONCLUSIONS: BCT may be beneficial, but given the time constraints, therapists need to be more rather than less skilled in cognitive therapy. This, plus methodological limitations, leads us to advise caution before applying this approach more widely in primary care.

Acute Disease↗

PubMed1996

Characteristics of homeless women living in London hostels.

To increase knowledge of homeless women in Britain, 49 female residents of two hostels were interviewed. The median age was 31 years, two-thirds had never married, and nearly three-fourths were born in England. When the sample was divided into younger and older groups by median age, significantly more black women were in the younger group. Older women had more serious mental illnesses and more problems with addiction. Median length of stay in the hostels was much shorter than the median time since becoming homeless, supporting other findings that women form a "hidden-homeless" subgroup. The findings suggest that younger and older homeless women may have different health and social service needs.

Adult↗