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Groningen, Netherlands

Van Oosterhout B.,GGzE | Smit F.,Trimbos Institute Netherlands Institute of Mental Health and Addiction | Smit F.,VU University Amsterdam | Krabbendam L.,VU University Amsterdam | And 5 more authors.
Psychological Medicine

Background. Metacognitive training (MCT) for schizophrenia spectrum is widely implemented. It is timely to systematically review the literature and to conduct a meta-analysis. Method. Eligible studies were selected from several sources (databases and expert suggestions). Criteria included comparative studies with a MCT condition measuring positive symptoms and/or delusions and/or data-gathering bias. Three meta-analyses were conducted on data gathering (three studies; 219 participants), delusions (seven studies; 500 participants) and positive symptoms (nine studies; 436 participants). Hedges' g is reported as the effect size of interest. Statistical power was sufficient to detect small to moderate effects. Results. All analyses yielded small non-significant effect sizes (0.26 for positive symptoms; 0.22 for delusions; 0.31 for data-gathering bias). Corrections for publication bias further reduced the effect sizes to 0.21 for positive symptoms and to 0.03 for delusions. In blinded studies, the corrected effect sizes were 0.22 for positive symptoms and 0.03 for delusions. In studies using proper intention-to-treat statistics the effect sizes were 0.10 for positive symptoms and -0.02 for delusions. The moderate to high heterogeneity in most analyses suggests that processes other than MCT alone have an impact on the results. Conclusions. The studies so far do not support a positive effect for MCT on positive symptoms, delusions and data gathering. The methodology of most studies was poor and sensitivity analyses to control for methodological flaws reduced the effect sizes considerably. More rigorous research would be helpful in order to create enough statistical power to detect small effect sizes and to reduce heterogeneity. Limitations and strengths are discussed. Copyright © Cambridge University Press 2015. Source

Zhang L.,University of Groningen | Opmeer E.M.,University of Groningen | Ruhe H.G.,University of Groningen | Aleman A.,University of Groningen | And 2 more authors.
NeuroImage: Clinical

Objectives Reflecting on the self and on others activates specific brain areas and contributes to metacognition and social cognition. The aim of the current study is to investigate brain activation during self- and other-reflection in patients with bipolar disorder (BD). In addition, we examined whether potential abnormal brain activation in BD patients could distinguish BD from patients with schizophrenia (SZ). Methods During functional magnetic resonance imaging (fMRI), 17 BD patients, 17 SZ patients and 21 healthy controls (HCs) performed a self-reflection task. The task consisted of sentences divided into three conditions: self-reflection, other-reflection and semantic control. Results BD patients showed less activation in the posterior cingulate cortex (PCC) extending to the precuneus during other-reflection compared to HCs (p = 0.028 FWE corrected on cluster-level within the regions of interest). In SZ patients, the level of activation in this area was in between BD patients and HCs, with no significant differences between patients with SZ and BD. There were no group differences in brain activation during self-reflection. Moreover, there was a positive correlation between the PCC/precuneus activation during other-reflection and cognitive insight in SZ patients, but not in BD patients. Conclusions BD patients showed less activation in the PCC/precuneus during other-reflection. This may support an account of impaired integration of emotion and memory (evaluation of past and current other-related information) in BD patients. Correlation differences of the PCC/precuneus activation with the cognitive insight in patients with BD and SZ might reflect an important difference between these disorders, which may help to further explore potentially distinguishing markers. © 2015 Published by Elsevier Inc. Source

Batstra L.,University of Groningen | Nieweg E.H.,Lentis Psychiatric Institute | Hadders-Algra M.,University of Groningen
Acta Paediatrica, International Journal of Paediatrics

The number of children diagnosed with attention deficit hyperactivity disorder (ADHD) and treated with medication is steadily increasing. The aim of this paper was to critically discuss five debatable assumptions on ADHD that may explain these trends to some extent. These are that ADHD (i) causes deviant behaviour, (ii) is a disease, (iii) is chronic and (iv) is best treated by medication and (v) that classification should precede treatment. Conclusion We argue that ADHD is not a disease, not the cause of deviant behaviour and in most cases not chronic. Treatment for attention and hyperactivity problems could start with psychosocial interventions and without a diagnostic label. A stepped diagnosis approach may reduce overdiagnosis without risking undertreatment. ©2014 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd. Source

van Balkom I.D.C.,Child and Adolescent Psychiatry Clinic | van Balkom I.D.C.,Lentis Psychiatric Institute | van Balkom I.D.C.,University of Groningen | Bresnahan M.,Columbia University | And 8 more authors.

Objective: The aim of this study was to examine paternal age in relation to risk of autism spectrum disorders (ASDs) in a setting other than the industrialized west. Design: A case-control study of Aruban-born children (1990-2003). Cases (N = 95) were identified at the Child and Adolescent Psychiatry Clinic, the only such clinic in Aruba; gender and age matched controls (N = 347) were gathered from public health records. Parental age was defined categorically (≤29, 30-39, 40-49, ≥50y). The analysis was made, using conditional logistic regression. Results: Advanced paternal age was associated with increased risk of ASDs in offspring. In comparison to the youngest paternal age group (≤29y), risk of autism increased 2.18 times for children born from fathers in their thirties, 2.71 times for fathers in their forties, and 3.22 thereafter. Conclusion: This study, part of the first epidemiologic study of autism in the Caribbean, contributes additional evidence, from a distinctive sociocultural setting, of the risk of ASD associated with increased paternal age. © 2012 van Balkom et al. Source

Castelein S.,Lentis Psychiatric Institute | Castelein S.,University of Groningen | Bruggeman R.,University of Groningen | Davidson L.,Yale University | And 2 more authors.
Schizophrenia Bulletin

People with psychotic disorders frequently experience significant mental and social limitations that may result in persisting social isolation. Research has shown that a supportive social environment is crucial for the process of personal recovery. Peer support groups can provide an opportunity to reduce isolation and enhance the process of personal recovery. It encourages people to express their thoughts, feelings, and personal concerns in a peer-to-peer learning environment. Although the importance of peer support groups for various chronic diseases is widely acknowledged, they do not generally form part of routine care for people with psychotic disorders. The evidence base is promising, but the field could benefit from more rigorous, pragmatic trials with follow-up measurements to establish a solid evidence-base. This article briefly reviews the literature and discusses the barriers to implementation of a peer-support learning environment in routine care, as well as ways to overcome these. © 2015 The Author. Source

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