Effects of telephone support on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease: a meta-analysis

The aim of this meta-analysis was to evaluate the effects of disease education or pulmonary rehabilitation programs assisted with telephone support on physical capacity and quality of life (QOL) in chronic obstructive pulmonary disease (COPD) patients. A systematic search of PubMed, Embase, Web of Science and The Cochrane Library was conducted until May 2017. Randomized controlled trials (RCTs) examining the effects of telephone-assisted intervention versus a control group on exercise tolerance and QOL in patients with COPD were included. Two independent authors assessed the methodological quality of the trials using the Cochrane risk of bias tool. A meta-analysis was conducted with the Revman5.3 to quantify the effects of telephone-assisted interventions on walking capacity and QOL. In total, 10 studies involving 1037 participants were included. Due to the effect of telephone-assisted interventions, statistically significant results were found on Saint-George’s Respiratory Questionnaire (SGRQ) symptom scores [standard mean difference (SMD) ?.18, 95% confidence interval (CI) ?.33, ?.03, p-value .02)], SGRQ impact scores [SMD ?.35, 95% CI ?.60, ?.10, p-value .006)], SGRQ activity scores [SMD ?.30, 95% CI ?.45, ?.15, p-value < .0001)], SGRQ total score [SMD ?.36, 95% CI ?.51, ?.21, p-value < .00001)]. The effects on 6-min walk test (6MWT) and all Chronic Respiratory Questionnaire (CRQ) subscales were not significant (p > .05) based on the insufficient evidence. In conclusion, the role of telephone-assisted interventions in the management of COPD remains equivocal. Some encouraging results were seen with regard to SGRQ symptom, SGRQ impact, SGRQ activity and SGRQ total score. We believe that more methodologically rigorous large-scale randomized controlled trials are necessary to answer this study question.     

Support groups for parents with an adult child suffering from bipolar disorder

Confronted with the disconcerting behaviour exhibited by their children, parents of bipolar patients are in severe distress. Research focuses on the study of the ‘burden’ that the pathology puts on caregivers, owing to their experience of depression, sometimes combined with the presence of hostile attitudes and negative affects. In France, parents of adult patients encounter an initial specific difficulty: they are not systematically included in the care management system. Thanks to the initiative of an association of psychiatrists and psychoanalysts, the authors set up a psychoanalytic support group for the parents of ‘bipolar’ adults. The diagnosis of a bipolar disorder is established by a psychiatrist within a medical structure. Support groups for parents do exist in France, but their experiences have not led to scientific publications on this specific topic. Existing publications focus on other types of pathology and other therapeutic approaches. In this article, we will highlight how this type of psychoanalytic support group, with operating rules based on the theoretical work of Anzieu, can help parents of patients with bipolar disorders. Group participants accepted the principle of a research study that maintained their anonymity. We collected and analysed qualitative data from the first year of the group, so we highlight the specific difficulties of these parents, faced with chronic disease. The relevance of our qualitative study also resides in the data collected over a period of time, enabling us to see the progress made, and encouraging us to reflect on the place of psychoanalytic groups for parents, as well as on the care management of this pathology.     

Reappraisal inventiveness: impact of appropriate brain activation during efforts to generate alternative appraisals on the perception of chronic stress in women*

Background and objectives: Previous research indicated that more left-lateralized prefrontal activation during cognitive reappraisal efforts was linked to a greater capacity for generating reappraisals, which is a prerequisite for the effective implementation of cognitive reappraisal in everyday life. The present study examined whether the supposedly appropriate brain activation is relevant in terms of more distal outcomes, i.e., chronic stress perception.

Design and methods: Prefrontal EEG alpha asymmetry was recorded while female participants were generating reappraisals for stressful events and was correlated with their self-reported chronic stress levels in everyday life (n?=?80).

Results: Women showing less left-lateralized brain activity in the ventrolateral prefrontal cortex during cognitive reappraisal efforts reported experiencing more stress in their daily lives. This effect was independent of self-efficacy beliefs in managing negative emotions.

Conclusion: These findings underline the practical relevance of individual differences in appropriate brain activation during emotion regulation efforts and the assumedly related basic capacity for the generation of cognitive reappraisals to the feeling of being stressed. Implications include the selection of interventions for the improvement of coping with stress in women in whom the capability for appropriate brain activation during reappraisal efforts may be impaired, e.g., due to depression or old age.     

Action‐semantic and syntactic deficits in subjects at risk for Huntington's disease

Frontostriatal networks play critical roles in grounding action semantics and syntactic skills. Indeed, their atrophy distinctively disrupts both domains, as observed in patients with Huntington's disease (HD) and Parkinson's disease, even during early disease stages. However, frontostriatal degeneration in these conditions may begin up to 15 years before the onset of clinical symptoms, opening avenues for pre‐clinical detection via sensitive tasks. Such a mission is particularly critical in HD, given that patients’ children have 50% chances of inheriting the disease. Against this background, we assessed whether deficits in the above‐mentioned domains emerge in subjects at risk to develop HD. We administered tasks tapping action semantics, object semantics, and two forms of syntactic processing to 18 patients with HD, 19 asymptomatic first‐degree relatives, and sociodemographically matched controls for each group. The patients evinced significant deficits in all tasks, but only those in the two target domains were independent of overall cognitive state. More crucially, relative to controls, the asymptomatic relatives were selectively impaired in action semantics and in the more complex syntactic task, with both patterns emerging irrespective of the subjects’ overall cognitive state. Our findings highlight the relevance of these dysfunctions as potential prodromal biomarkers of HD. Moreover, they offer theoretical insights into the differential contributions of frontostriatal hubs to both domains while paving the way for innovations in diagnostic procedures.     

Increasing the salience of fluency cues does not reduce the recognition memory impairment in Alzheimer's disease!

In Alzheimer's disease (AD), it is now well established that recollection is impaired from the beginning of the disease, whereas findings are less clear concerning familiarity. One of the most important mechanisms underlying familiarity is the sense of familiarity driven by processing fluency. In this study, we attempted to attenuate recognition memory deficits in AD by maximizing the salience of fluency cues in two conditions of a recognition memory task. In one condition, targets and foils have been created from the same pool of letters (Overlap condition). In a second condition, targets and foils have been derived from two separate pools of letters (No‐Overlap condition), promoting the use of letter‐driven visual and phonetic fluency. Targets and foils were low‐frequency words. The memory tasks were performed by 15 patients with AD and 16 healthy controls. Both groups improved their memory performance in the No‐Overlap condition compared to the Overlap condition. Patients with AD were able to use fluency cues during recognition memory as older adults did, but this did not allow to compensate for dysfunction of recognition memory processes.     

An experimental test to reveal negative side-effects of high treatability information on preventative health behaviour

Objectives: When the course of a disease can be positively changed by health professionals the disease can be indicated as ‘highly treatable’. This ‘high treatability information’ (HTI) may have negative side-effects on people’s preventative motivation. This study examined the effects of HTI regarding skin cancer on preventative motivation.

Design: This study employed a 2 (high treatability (HTI) versus low treatability (LTI)) × 2 (high versus low susceptibility)?experiment with a hanging control group. (family) History and self-efficacy were assessed as moderators. Participants (N = 309) were randomly assigned to one of the five conditions.

Main outcome measures: The main outcome was intention to engage in preventative actions regarding skin cancer.

Results: HTI significantly lowered the intention compared to LTI, under the condition of high susceptibility in people with low self-efficacy. In addition, in people with a (family) history of skin cancer, HTI significantly lowered the intention compared to the no-information group.

Conclusion: HTI regarding skin cancer can cause a drop in the preventative motivation. The effects can be conceptualised as negative side-effects of HTI. As substantial proportions of the general population have a (family) history of skin cancer or low self-efficacy, the side-effects may be widespread, possibly increasing the incidence of skin cancer.     

The Visual Spatial Learning Test: Differential impairment during the premanifest and manifest stages of Huntington's disease

Visual spatial memory was assessed using the Visual Spatial Learning Test (VSLT) in individuals with mild to moderate Huntington's disease (HD), pre‐manifest gene carriers for HD, and demographically similar controls. The VSLT has been demonstrated to be a valid, normed measure of non‐verbal memory involving minimal motoric responses. The VSLT assesses immediate and delayed memory for designs, positions of the designs, and design/position associations. The HD group was significantly impaired (p < .05) relative to both the control and Pre‐HD groups on immediate and delayed memory for the designs, positions, and design/position associations. Although there were no differences between the Pre‐HD and control groups on immediate or delayed memory for designs or positions, the Pre‐HD group was significantly impaired (p < .05) relative to the control group on immediate and delayed memory for design/position associations. The results offer novel insight into a relatively unexamined memory deficit that may occur in gene carriers for HD prior to phenoconversion. The data indicate that the VSLT may be a useful measure of visuospatial memory during the premanifest and manifest stages of HD.     

Attention network test: Assessment of cognitive function in chronic fatigue syndrome

Information processing difficulties are common in patients with chronic fatigue syndrome (CFS). It has been shown that the time it takes to process a complex cognitive task, rather than error rate, may be the critical variable underlying CFS patients' cognitive complaints. The Attention Network Task (ANT) developed by Fan and colleagues may be of clinical utility to assess cognitive function in CFS, because it allows for simultaneous assessment of mental response speed, also called information processing speed, and error rate under three conditions challenging the attention system. Comparison of data from two groups of CFS patients (those with and without comorbid major depressive disorder; n = 19 and 22, respectively) to controls (n = 29) consistently showed that error rates did not differ among groups across conditions, but speed of information processing did. Processing time was prolonged in both CFS groups and most significantly affected in response to the most complex task conditions. For simpler tasks, processing time was only prolonged in CFS participants with depression. The data suggest that the ANT may be a task that could be used clinically to assess information processing deficits in individuals with CFS.