Systematic review of the diagnostic category muscle dysmorphia.

OBJECTIVES: (1) To collect, analyze and synthetize the evidence on muscle dysmorphia diagnosis as defined by Pope et al. and (2) To discuss its appropriate nosology and inclusion as a specific category in psychiatric classificatory systems. METHOD: A systematic search in the MEDLINE, the PsycNET, the LILACS and SciELO databases and in the International Journal of Eating Disorders was conducted looking for articles published between January 1997 and October 2014 and in EMBASE database between January 1997 and August 2013. Only epidemiological and analytical studies were considered for selection. The methodological quality of included studies was assessed according to the Evidence-Based Mental Health and the National Health and Medical Research Council's guidelines. The support for inclusion of muscle dysmorphia in psychiatric classificatory systems was examined against Blashfield et al.'s criteria. RESULTS: Thirty-four articles were considered eligible out of 5136. Most of the studies were cross-sectional and enrolled small, non-clinical samples. The methodological quality of all selected papers was graded at the lowest hierarchical level due to studies' designs. Forty-one percent of the publications considered the available evidence insufficient to support the inclusion of muscle dysmorphia in any existing category of psychiatric disorders. The current literature does not fulfill Blashfield et al.'s criteria for the inclusion of muscle dysmorphia as a specific entity in psychiatric diagnostic manuals. CONCLUSION: The current evidence does not ensure the validity, clinical utility, nosological classification and inclusion of muscle dysmorphia as a new disorder in classificatory systems of mental disorders.

Systematic review of the literature on clinical and experimental trials on the antitumor effects of cannabinoids in gliomas.

To evaluate, through a systematic review of the literature, the antitumoral effects of cannabinoids on gliomas. Research included the following electronic databases: PUBMED, EMBASE, LILACS and The Cochrane Collaboration Controlled Trials Register. All published studies involving the antitumoral effects (cellular and molecular mechanisms) of cannabinoids were considered for this review. The bibliography search strategy included all publications of each of these databases until December 31, 2012. From 2,260 initially identified articles, 35 fulfilled the inclusion criteria for this review. All the studies included in this systematic review were experimental (in vivo and/or in vitro), except for one pilot clinical trial phase I/II involving humans. In all experimental studies included, cannabinoids exerted antitumoral activity in vitro and/or antitumoral evidence in vivo in several models of tumor cells and tumors. The antitumor activity included: antiproliferative effects (cell cycle arrest), decreased viability and cell death by toxicity, apoptosis, necrosis, autophagy, as well as antiangiogenic and antimigratory effects. Antitumoral evidence included: reduction in tumor size, antiangiogenic, and antimetastatic effects. Additionally, most of the studies described that the canabinnoids exercised selective antitumoral action in several distinct tumor models. Thereby, normal cells used as controls were not affected. The safety factor in the cannabinoids' administration has also been demonstrated in vivo. The various cannabinoids tested in multiple tumor models showed antitumoral effects both in vitro and in vivo. These findings indicate that cannabinoids are promising compounds for the treatment of gliomas.

Validity studies of quality of life instruments for eating disorders: systematic review of the literature.

To conduct a systematic review of studies that evaluated quality of life (QOL) among individuals with eating disorders, to analyze the characteristics of specific QOL instruments for eating disorders. Bibliographic searches were conducted in 6 databases and manual searches in 2 journals, covering the period from January 1975 to June 2008. The search strategies provided a total of 29,537 references. Out of the 41 studies that met the inclusion criteria for this review, 5 reported on the validation process for 4 specific instruments for eating disorders. Among the 4 specific QOL instruments for eating disorders, 3 presented adequate development procedures and psychometric properties. However, further research is needed to prove the validity and applicability of these instruments. Additional validation studies are needed, especially in relation to patients who deny that they have a disorder.

[Quality of life and eating disorders: a systematic review]. / Qualidade de vida e transtornos alimentares: uma revisão sistemática.

This article provides a systematic review of articles on quality of life (QoL) among individuals with eating disorders. A literature search was conducted using six databases. Manual searches were also performed in two specialized journals, covering the period from January 1975 to June 2008. The search strategies identified a total of 29,537 articles. Forty-one studies met the inclusion criteria, and 36 were analyzed in the present review. Patients with eating disorders showed reduced QoL as compared to normal controls and individuals with other psychiatric disorders. The mental health component of QoL showed greater impairment than the physical component. Patients with binge eating disorders showed reduced physical and psychological QoL. We identified few studies on QoL in bulimia nervosa-only patients. QoL assessment of anorexia nervosa patients showed a modest impact on the physical domain. However, this finding should be interpreted with caution, since it may be due to an artifact in the disorder's psychopathology rather than better health status per se.

Qualidade de vida e transtornos alimentares: uma revisão sistemática / Quality of life and eating disorders: a systematic review

O objetivo foi fazer uma revisão sistemática dos estudos que avaliam qualidade de vida em pessoas com transtornos alimentares. Foram realizadas buscas bibliográficas em seis bases de dados e buscas manuais em duas revistas, abrangendo o período de janeiro de 1975 até junho de 2008. As estratégias de busca forneceram um total de 29.537 referências. Quarenta e um estudos preencheram os critérios de inclusão desta revisão e 36 foram analisados no presente trabalho. De modo geral, os estudos revelam prejuízos na qualidade de vida de pacientes com transtornos alimentares quando comparados a grupos normais ou outras patologias psiquiátricas. O aspecto mental da qualidade de vida mostra-se mais prejudicado. A avaliação da qualidade de vida em sujeitos com transtorno da compulsão alimentar periódica revela prejuízos nos aspectos físico e mental da qualidade de vida. Há pouca evidência e discussão para indivíduos com bulimia nervosa isoladamente. Em sujeitos com anorexia nervosa, a avaliação requer cautela, já que o aparente menor impacto físico pode ser reflexo da psicopatologia específica deste transtorno e não do funcionamento saudável.

This article provides a systematic review of articles on quality of life (QoL) among individuals with eating disorders. A literature search was conducted using six databases. Manual searches were also performed in two specialized journals, covering the period from January 1975 to June 2008. The search strategies identified a total of 29,537 articles. Forty-one studies met the inclusion criteria, and 36 were analyzed in the present review. Patients with eating disorders showed reduced QoL as compared to normal controls and individuals with other psychiatric disorders. The mental health component of QoL showed greater impairment than the physical component. Patients with binge eating disorders showed reduced physical and psychological QoL. We identified few studies on QoL in bulimia nervosa-only patients. QoL assessment of anorexia nervosa patients showed a modest impact on the physical domain. However, this finding should be interpreted with caution, since it may be due to an artifact in the disorder's psychopathology rather than better health status per se.

Antidepressants in short-term treatment of binge eating disorder: systematic review and meta-analysis.

OBJECTIVE: To evaluate the effects of antidepressant interventions for patients with Binge Eating Disorder (BED). METHOD: A systematic review and meta-analysis of available randomized controlled trials including a quality appraisal was conducted. Six databases: PUBMED, EMBASE, PSYINFO, LILACS, The Cochrane Collaboration Controlled Trials Register and The Cochrane Depression, Anxiety and Neurosis Group Database of Trials were searched using an electronic search strategy. Articles published during the period from January 1994 to December 2005 were included. RESULTS: From the 3357 articles initially identified, 19 full manuscripts were selected and analyzed and 7 studies fulfilled the inclusion criteria and were included in the final analysis. Data from the meta-analysis revealed that binge-eating remission rates were higher in patients receiving antidepressants when compared with placebo. No difference in body weight has been found as measured by short-term change in body mass index. Most studies were short-term trials (median duration: 8 weeks). The only 16-week duration study did not show superiority of antidepressants over placebo. CONCLUSION: Available data are not sufficient to formally recommend antidepressants as a single first line therapy for both short-term remission of binge-eating episodes and weight reduction in patients with BED. BED is a chronic condition and very short-term studies (8 weeks) may be of limited value.