Aromatherapy for dementia (Review)

Background Medications licensed for the treatment of dementia have limited efficacy against cognitive impairment or against the distressed behaviours (behavioural and psychological symptoms, or behaviour that challenges) which are also often the most distressing aspect of the disorder for caregivers. Complementary therapies, including aromatherapy, are attractive to patients, practitioners and families, because they are perceived as being unlikely to cause adverse effects. Therefore there is interest in whether aromatherapy might offer a safe means of alleviating distressed behaviours in dementia. Objectives To assess the efficacy and safety of aromatherapy for people with dementia. Search methods We searched ALOIS, the Cochrane Dementia and Cognitive Improvement Group Specialized Register, on 5 May 2020 using the terms: aromatherapy, lemon, lavender, rose, aroma, alternative therapies, complementary therapies, essential oils. In addition, we searched MEDLINE, Embase, PsycINFO (all via Ovid SP), Web of Science Core Collection (via Thompson Web of Science), LILACS (via BIREME), CENTRAL (via the Cochrane Library), ClinicalTrials.gov and the World Health Organization (WHO) trials portal (ICTRP) on 5 May 2020. Selection criteria We included randomised controlled trials which compared fragrance from plants in an intervention defined as aromatherapy for people with dementia with placebo aromatherapy or with treatment as usual. All doses, frequencies and fragrances of aromatherapy were considered. Participants in the included studies had a diagnosis of dementia of any subtype and severity. Data collection and analysis Two reviewers independently selected studies for inclusion, extracted data and assessed risk of bias in included studies, involving other authors to reach consensus decisions where necessary. We did not perform any meta-analyses because of heterogeneity between studies, but presented a narrative synthesis of results from the included trials. Because of the heterogeneity of analysis methods and inadequate or absent reporting of data from some trials, we used statistical significance (P ≤ or > 0.5) as a summary metric when synthesising results across studies. As far as possible, we used GRADE methods to assess our confidence in the results of the trials, downgrading for risk of bias and imprecision. Aromatherapy for dementia (Review) Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 1 Cochrane Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews Main results We included 13 studies with 708 participants. All participants had dementia and in the 12 trials which described the setting, all were resident in institutional care facilities. Nine trials recruited participants because they had significant agitation or other behavioural and psychological symptoms in dementia (BPSD) at baseline. The fragrances used were lavender (eight studies); lemon balm (four studies); lavender and lemon balm, lavender and orange, and cedar extracts (one study each). For six trials, assessment of risk of bias and extraction of results was hampered by poor reporting. Four of the other seven trials were at low risk of bias in all domains, but all were small (range 18 to 186 participants; median 66), reducing our confidence in the results. Our primary outcomes were agitation, overall behavioural and psychological symptoms, and adverse effects. Ten trials assessed agitation using various scales. Among the five trials for which our confidence in the results was moderate or low, four trials reported no significant effect on agitation and one trial reported a significant benefit of aromatherapy. The other five trials either reported no useable data or our confidence in the results was very low. Eight trials assessed overall BPSD using the Neuropsychiatric Inventory and we had moderate or low confidence in the results of five of them. Of these, four reported significant benefit from aromatherapy and one reported no significant effect. Adverse events were poorly reported or not reported at all in most trials. No more than two trials assessed each of our secondary outcomes of quality of life, mood, sleep, activities of daily living, caregiver burden. We did not find evidence of benefit on these outcomes. Three trials assessed cognition: one did not report any data and the other two trials reported no significant effect of aromatherapy on cognition. Our confidence in the results of these studies was low. Authors' conclusions We have not found any convincing evidence that aromatherapy (or exposure to fragrant plant oils) is beneficial for people with dementia although there are many limitations to the data. Conduct or reporting problems in half of the included studies meant that they could not contribute to the conclusions. Results from the other studies were inconsistent. Harms were very poorly reported in the included studies. In order for clear conclusions to be drawn, better design and reporting and consistency of outcome measurement in future trials would be needed

Seksuālas, uzmācīgas domas pacientiem vīriešiem ar obsesīvi - kompulsīviem traucējumiem

MedicīnaVeselības aprūpeMedicineHealth CareObsesīvi-kompulsīvi traucējumi ir izplatīti, parasti hroniski garīgi traucējumi, kas saistīti ar augstu globālo invaliditāti. 65,3% ziņoja par smagiem traucējumiem. Šo traucējumu raksturo uzmācīgas un satraucošas domas (apsēstības) un atkārtotas uzvedības (piespiešanas), kuras personai ir nepieciešams veikt, lai “neitralizētu” obsesīvās domas. Lai gan tiek ziņots, ka apsēstības ar piesārņojumu ir visizplatītākais obsesijas veids OKT gadījumā, seksuālās apsēstības nav nekas neparasts OKT pacientu vidū (30,2% cilvēku ar OKT ziņoja par seksuālām un/vai reliģiskām apsēstībām). Un tas ir īpaši satraucoši personām, kuras tās piedzīvo OKT var izpausties manā veidā, un ar tās izpausmēm ir saistīti vairāki faktori. Un dzimums, šķiet, ir viens no tiem. Tomēr dažādu pētījumu rezultāti ir pretrunīgi un par to ir veikts mazāk pētījumu, salīdzinot ar citiem simptomu aspektiem. Šķiet, ka dzimuma ietekmē ir sākuma vecums, gaita, simptomu dimensijas un blakusslimības. HIPOTĒZE: Pastāv saistība starp vīriešu dzimumu un obsesīvi-kompulsīvo traucējumu izpausmēm – īpaši seksuālu apsēstību, slimības gaitu un sākuma vecumu. MĒRĶIS: šī literatūras apskata mērķis ir sniegt pārskatu par esošajiem pētījumiem un pētījumiem, kas saistīti ar obsesīvi-kompulsīviem traucējumiem, seksuālām apsēstībām OKT personām un to, kā to ietekmē dzimums. METODOLOĢIJA: literatūras apskats tika sastādīts, izmantojot vairākus avotus – rakstus, datu bāzes, publikācijas, kas ietvēra PubMed, science direct, Elsevier, NCBI.Obsessive-compulsive disorder is a common, usually chronic mental disorder that is associated with high global disability. 65.3% reporting severe impairment. This disorder is characterized by intrusive and distressing thoughts(obsessions) and repetitive behaviors(compulsions) that the person feels the need to perform to “neutralize” the obsessive thoughts . Even though contamination obsessions are reported to be the most common type of obsessions in OCD, sexual obsessions are not uncommon among OCD patients (30.2% of people with OCD reported sexual and/or religious obsessions). And is particularly troubling to the individuals experiencing them OCD can manifest in my ways, and there are several factors linked to its manifestations. And gender seems to be one of them. However, the results across different studies are conflicting and there has been less research about it in comparison to other symptom dimensions. Age of onset, course, type of symptom dimensions, and comorbidities of the disorder, have all seem to be influenced by gender. HYPOTHESIS: There is an association between male gender and obsessive-compulsive disorder manifestations- particularly sexual obsessions, course of disease, and age of onset. AIM: of this literature review is to give an overview of the existing research and studies related to obsessive-compulsive disorder, sexual obsessions in OCD individuals, and how it is influenced by gender. METHODOLOGY: the literature review was composed using several sources – articles, databases, publications which included PubMed, science direct, Elsevier, NCBI