Pharmacological interventions for schizotypal personality disorder

This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the effects of pharmacological interventions for people with Schizotypal Personality Disorder (SzPD).http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009047/ful

Pharmacological interventions for paranoid personality disorder

This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the effects of pharmacological interventions for people with paranoid personality disorder (PPD).;http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009100/abstrac

Pharmacological interventions for schizotypal personality disorder

This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the effects of pharmacological interventions for people with Schizotypal Personality Disorder (SzPD).;http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009047.pub2/ful

Pharmacological interventions for antisocial personality disorder

Background Antisocial personality disorder (AsPD) is associated with a wide range of disturbance including persistent rule-breaking, criminality, substance misuse, unemployment, homelessness and relationship difficulties. Objectives To evaluate the potential beneficial and adverse effects of pharmacological interventions for people with AsPD. Search strategy We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2009, Issue 3), MEDLINE (1950 to September 2009), EMBASE (1980 to 2009, week 37), CINAHL (1982 to September 2009), PsycINFO (1872 to September 2009), ASSIA (1987 to September 2009), BIOSIS (1985 to September 2009), COPAC (September 2009), National Criminal Justice Reference Service Abstracts (1970 to July 2008), Sociological Abstracts (1963 to September 2009), ISI-Proceedings (1981 to September 2009), Science Citation Index (1981 to September 2009), Social Science Citation Index (1981 to September 2009), SIGLE (1980 to April 2006), Dissertation Abstracts (September 2009), ZETOC (September 2009) and the metaRegister of Controlled Trials (September 2009). Selection criteria Controlled trials in which participants with AsPD were randomly allocated to a pharmacological intervention and a placebo control condition. Two trials comparing one drug against another without a placebo control are reported separately. Data collection and analysis Three review authors independently selected studies. Two review authors independently extracted data. We calculated mean differences, with odds ratios for dichotomous data. Main results Eight studies met the inclusion criteria involving 394 participants with AsPD. Data were available from four studies involving 274 participants with AsPD. No study set out to recruit participants solely on the basis of having AsPD, and in only one study was the sample entirely of AsPD participants. Eight different drugs were examined in eight studies. Study quality was relatively poor. Inadequate reporting meant the data available were generally insufficient to allow any independent statistical analysis. The findings are limited to descriptive summaries based on analyses carried out and reported by the trial investigators. All the available data were derived from unreplicated single reports. Only three drugs (nortriptyline, bromocriptine, phenytoin) were effective compared to placebo in terms of improvement in at least one outcome. Nortriptyline was reported in one study as superior for men with alcohol dependency on mean number of drinking days and on alcohol dependence, but not for severity of alcohol misuse or on the patient's or clinician's rating of drinking. In the same study, both nortriptyline and bromocriptine were reported as superior to placebo on anxiety on one scale but not on another. In one study, phenytoin was reported as superior to placebo on the frequency and intensity of aggressive acts in male prisoners with impulsive (but not premeditated) aggression. In the remaining two studies, both amantadine and desipramine were not superior to placebo for adults with opioid and cocaine dependence, and desipramine was not superior to placebo for men with cocaine dependence. Authors' conclusions The body of evidence summarised in this review is insufficient to allow any conclusion to be drawn about the use of pharmacological interventions in the treatment of antisocial personality disorder.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007667.pub2/ful

Psychological interventions for antisocial personality disorder

Background Antisocial personality disorder (AsPD) is associated with a wide range of disturbance including persistent rule-breaking, criminality, substance use, unemployment, homelessness and relationship difficulties. Objectives To evaluate the potential beneficial and adverse effects of psychological interventions for people with AsPD. Search strategy Our search included CENTRAL Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycINFO, ASSIA, BIOSIS and COPAC. Selection criteria Prospective, controlled trials in which participants with AsPD were randomly allocated to a psychological intervention and a control condition (either treatment as usual, waiting list or no treatment). Data collection and analysis Three authors independently selected studies. Two authors independently extracted data. We calculated mean differences, with odds ratios for dichotomous data. Main results Eleven studies involving 471 participants with AsPD met the inclusion criteria, although data were available from only five studies involving 276 participants with AsPD. Only two studies focused solely on an AsPD sample. Eleven different psychological interventions were examined. Only two studies reported on reconviction, and only one on aggression. Compared to the control condition, cognitive behaviour therapy (CBT) plus standard maintenance was superior for outpatients with cocaine dependence in one study, but CBT plus treatment as usual was not superior for male outpatients with recent verbal/physical violence in another. Contingency management plus standard maintenance was superior for drug misuse for outpatients with cocaine dependence in one study but not in another, possibly because of differences in the behavioural intervention. However, contingency management was superior in social functioning and counselling session attendance in the latter. A multi-component intervention utilising motivational interviewing principles, the 'Driving Whilst Intoxicated program', plus incarceration was superior to incarceration alone for imprisoned drink-driving offenders. Authors' conclusions Results suggest that there is insufficient trial evidence to justify using any psychological intervention for adults with AsPD. Disappointingly few of the included studies addressed the primary outcomes defined in this review (aggression, reconviction, global functioning, social functioning, adverse effects). Three interventions (contingency management with standard maintenance; CBT with standard maintenance; 'Driving Whilst Intoxicated program' with incarceration) appeared effective, compared to the control condition, in terms of improvement in at least one outcome in at least one study. Each of these interventions had been originally developed for people with substance misuse problems. Significant improvements were mainly confined to outcomes related to substance misuse. No study reported significant change in any specific antisocial behaviour. Further research is urgently needed for this prevalent and costly condition.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007668.pub2/ful

Psychological interventions for people with narcissistic personality disorder

This is the protocol for a review and there is no abstract. The objectives are as follows: This review aims to evaluate the potential beneficial and adverse effects of psychological interventions for people with narcissistic personality disorder. Copyright © 2014 The Cochrane Collaboration. Reason for withdrawal from publication: Authors have made no progress with this protocol in over a year due to difficulties with identifying potentially suitable studies. The protocol has been withdrawn.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009690.pub2/abstrac

Psychological interventions for obsessive-compulsive personality disorder

This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the potential beneficial and adverse effects of psychological interventions for people with obsessive-compulsive personality disorder and to make recommendations for future areas of research.;http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008518/ful

Pharmacological interventions for obsessive-compulsive personality disorder

This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the potential beneficial and adverse effects of pharmacological interventions for people with obsessive-compulsive personality disorder and to make recommendations for future areas of research.;http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008517/ful

The Effect of Subsidence on Segmental and Global Lordosis at Long-term Follow-up After Anterior Cervical Discectomy and Fusion

Objective Subsidence following anterior cervical discectomy and fusion (ACDF) may lead to disruptions of cervical alignment and lordosis. The purpose of this study was to evaluate the effect of subsidence on segmental, regional, and global lordosis. Methods This was a retrospective cohort study performed between 2016–2021 at a single institution. All measurements were performed using lateral cervical radiographs at the immediate postoperative period and at final follow-up greater than 6 months after surgery. Associations between subsidence and segmental lordosis, total fused lordosis, C2–7 lordosis, and cervical sagittal vertical alignment change were determined using Pearson correlation and multivariate logistic regression analyses. Results One hundred thirty-one patients and 244 levels were included in the study. There were 41 one-level fusions, 67 two-level fusions, and 23 three-level fusions. The median follow-up time was 366 days (interquartile range, 239–566 days). Segmental subsidence was significantly negatively associated with segmental lordosis change in the Pearson (r = -0.154, p = 0.016) and multivariate analyses (beta = -3.78; 95% confidence interval, -7.15 to -0.42; p = 0.028) but no associations between segmental or total fused subsidence and any other measures of cervical alignment were observed. Conclusion We found that subsidence is associated with segmental lordosis loss 6 months following ACDF. Surgeons should minimize subsidence to prevent long-term clinical symptoms associated with poor cervical alignment