A meta-analysis and theoretical critique of oxytocin and psychosis: Prospects for attachment and compassion in promoting recovery.
Objectives There is now considerable evidence that affiliative processes are linked to oxytocin ( OXT), which is linked to a range of social-cognition competences underpinning interpersonal functioning. There is evidence that OXT circuitry is involved in psychosis and emerging evidence for OXT in tr...
| Publicado en: | British Journal of Clinical Psychology Vol. 53; no. 1; pp. 42 - 62 |
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| Autores principales: | , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Mar2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104033122&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104033122 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01446657 99B jtl: British Journal of Clinical Psychology issn: 01446657 maglogo: Y pubinfo: dt: Mar2014 vid: 53 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104033122 94609364 10.1111/bjc.12041 NLM24588761 104033122 ppf: 42 ppct: 20 formats: fmt: @attributes: type: P tig: atl: A meta-analysis and theoretical critique of oxytocin and psychosis: Prospects for attachment and compassion in promoting recovery. aug: au: Gumley, Andrew Braehler, Christine Macbeth, Angus affil: Institute of Health and Wellbeing, University of Glasgow sug: subj: Oxytocin Administration and Dosage Psychotic Disorders Drug Therapy Human Systematic Review Meta Analysis Descriptive Statistics Confidence Intervals CINAHL Database Embase Medline Psycinfo Clinical Trial Registry Male Adult Middle Age Adult: 19-44 years Middle Aged: 45-64 years Male ab: Objectives There is now considerable evidence that affiliative processes are linked to oxytocin ( OXT), which is linked to a range of social-cognition competences underpinning interpersonal functioning. There is evidence that OXT circuitry is involved in psychosis and emerging evidence for OXT in treatment. Therefore, this study explored studies investigating OXT and improvements in symptoms and social cognition among individuals diagnosed with psychosis. Method We conducted a systematic review of randomized controlled trials investigating OXT and psychosis. Specifically we asked, (1) what is the evidence that OXT is associated with improved overall, positive, negative and general symptoms and (2) what is the evidence that OXT is associated with improved social cognition? Results There were seven randomized controlled trials that met the inclusion criteria for this review. We conducted an exploratory meta-analysis of data from four of these studies on a total sample size of n = 105. For overall symptoms, using a random-effects model OXT versus placebo was associated with an effect size of d = 0.52 (95% CI = 0.34-0.70; z = 5.66; p < .01). There was evidence of significant heterogeneity ( Q = 96.4, p < .001; I2 = 96.5%). Similar patterns of findings were observed for positive, negative, and general symptoms. We found significant evidence of high risk of bias across all studies. We also identified that one particular study had an undue effect on overall effect size estimates. Finally, evidence regarding OXT was linked to improved social cognition was inconsistent. Conclusions There are significant problems in interpreting the current evidence base for OXT in psychosis. However, OXT may provide a useful biomarker for exploring mechanisms of change occurring in psychological therapies including compassion-focused therapy (CFT), which through its engagement of the attachment system may directly influence OXT. Practitioner points Positive clinical implications Practitioners should consider the attachment and/or interpersonal context of both psychological and pharmacological therapies., There may be a specific role CFT in fostering social cognition and mentalization as a context for emotional and psychiatric recovery., Future clinical trials of CFT in psychosis could consider mapping changes in social cognition onto changes in OXT thereby linking important domains of emotional and social recovery to underlying and salient neurophysiological systems., Limitations Small number of studies included in the review., Not possible to determine mechanisms of change in trials of OXT. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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