Cochrane evidence on managing depression, schizophrenia and autism spectrum disorders

Two more mental health reviews published in Issue 10 in The Cochrane Library are the subject of excellent blogs from The Mental Elf. These new reviews, from the Cochrane Depression, Anxiety and Neurosis Group and the Cochrane Schizophrenia Group, look at the evidence on duloxetine compared with other drugs for depression, and on information and communication technology in patient education and support for people with schizophrenia. A third blog neatly summarises a new review from the Cochrane Developmental, Psychosocial and Learning Problems Group on the effectiveness of Early Intensive Behavioural Intervention for children with autism spectrum disorders, an approach which is widely used with the aim of improving functional behaviours and skills in these children. They’re well worth reading and you can find them from the links below. Continue reading

Taking a complex approach to depression and anxiety

If you’re making a trifle, you expect to put in lots of different ingredients, but opinion varies about what should go in. Are those vaguely stale-tasting sponge fingers vital for the optimal trifle or does Swiss roll provide a superior foundation? Some consider jelly trifleto be a vital element, while others wouldn’t consider it. Fruit – tinned or fresh, and what sort? Cream or custard? Chocolate shavings (for the aspirational trifle), sugar strands or good old silver balls? The truth is, we don’t know which elements and which combinations work best, though every trifle maker will have their own ideas about that. The process may be standardized but the form of the thing will be adapted. A key question then is did it hit the spot and leave your consumers feeling much better for it? Continue reading

Smoking: helping people stop and stopping them from starting

adviceSmoking, with its enormous implications for health, is a high profile health topic, and the spotlight is firmly on it this month as the Department of Health’s ‘Stoptober’ smoking cessation campaign continues. Sir Richard Peto, giving the Harveian Oration, Halving premature death, at the Royal College of Physicians on Thursday, named smoking as one of the “four corpsemen of the Apocalypse”, along with alcohol, obesity and HIV. Continue reading

Can incentives encourage children and teens to resist smoking?

The other side of the smoking coin is, of course, prevention, with children and young people being a key target for initiatives designed to stop people becoming smokers. The second new review looked at whether incentives are effective in preventing children and adolescents from starting to smoke. Continue reading

New evidence on how to help people with chronic heart failure stay out of hospital

There’s such a lot of interesting and important evidence from the latest batch of reviews. Two updated reviews are featured this week in the BMJ. The first of these, from the Cochrane Heart Group, assessed the effectiveness of disease management interventions for patients with chronic heart failure (CHF), a serious condition affecting mostly elderly people, which is becoming increasingly common as our population ages.

Key message: case management interventions reduced death rates and hospital readmissions in chronic heart failure patients. Continue reading

Now cranberries are just for Christmas – new evidence suggests cranberry juice unlikely to prevent urinary tract infections

Key message: The current evidence suggests that any benefit of taking cranberry products to prevent urinary tract infection is likely to be small and people may find taking them over a long period of time unacceptable.

As garlic is to vampires, so cranberries are to urinary tract infections (UTIs); or so many people believe, drinking cranberry juice in the hope of avoiding bouts of this unpleasant complaint. Cranberry products have been used for this purpose for a very long time and though it’s unclear how they might help, one theory is that cranberries prevent bacteria from sticking to the walls of the bladder. Continue reading

Keeping the over-65s on their feet: new review evidence tells us how

Keeping the over-65's on their feet

Keeping the over-65’s on their feet

The second review, from the Cochrane Bone, Joint and Muscle Trauma Group, looked at falls prevention interventions for people aged over 65 living in the community. This review is really important for all those working to prevent falls in this population, around 30% of whom will fall each year.Key message: group exercise classes and exercises at home are amongst a number of strategies found to help prevent falls in people aged over 65 living in the community. Continue reading