Intranasal Oxytocin May Improve High-Level Social Cognition in Schizophrenia, But Not Social Cognition or Neurocognition in General: A Multilevel Bayesian Meta-analysis
Intranasal Oxytocin May Improve High-Level Social Cognition in Schizophrenia, But Not Social Cognition or Neurocognition in General: A Multilevel Bayesian Meta-analysis
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DOI：
10.1093/schbul/sbx053
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发表时间：
2017-11-01
影响因子：
6.6
通讯作者：
Woolley, Josh D.
中科院分区：
文献类型：
--
作者：
Burkner, Paul-Christian;Williams, Donald R.;Woolley, Josh D.
虽然人们对鼻腔内应用催产素(IN-OT)改善精神分裂症患者的社会认知和神经认知(即非社会认知)的潜力越来越感兴趣，但现有的文献却喜忧参半。在这里，我们对IN-OT改善精神分裂症患者社会和神经认知领域的有效性进行了贝叶斯荟萃分析。对原始研究出版物的系统搜索确定了IN-OT的随机对照试验(RCT)作为纳入纳入的精神分裂症的社会和神经认知缺陷的治疗方法。在多水平贝叶斯模型中使用标准化均值差(SMD)和相应的方差来获得荟萃分析效应大小估计。在总共12项研究(N=273)中，IN-OT没有改善社会认知(SMD=0.07，95%可信区间[CI]=[-0.06，0.17])或神经认知(SMD=0.12，95%CI=[-0.12，0.34])。社会认知结果的研究异质性中等(tau(S)=0.12)调节变量分析显示，与低水平的社会认知(即社会线索知觉)相比，IN-OT对高水平的社会认知(即心灵化和心理理论)的影响显著更大(b=0.19，95%CI=[0.0 5，0.33])。当我们的分析局限于高水平社会认知的结果时，IN-OT有显著的影响(SMD=0.20，95%CI=[0.05，0.33])，但对敏感性分析的影响不强。本研究表明，IN-OT对高水平的社会认知可能具有选择性作用，这为今后IN-OT的研究提供了一个更具针对性的研究对象。
While there is growing interest in the potential for intranasal oxytocin (IN-OT) to improve social cognition and neurocognition (ie, nonsocial cognition) in schizophrenia, the extant literature has been mixed. Here, we perform a Bayesian meta-analysis of the efficacy of IN-OT to improve areas of social and neurocognition in schizophrenia. A systematic search of original research publications identified randomized controlled trials (RCTs) of IN-OT as a treatment for social and neurocognitive deficits in schizophrenia for inclusion. Standardized mean differences (SMD) and corresponding variances were used in multilevel Bayesian models to obtain meta-analytic effect-size estimates. Across a total of 12 studies (N = 273), IN-OT did not improve social cognition (SMD = 0.07, 95% credible interval [CI] = [-0.06, 0.17]) or neurocognition (SMD = 0.12, 95% CI = [-0.12, 0.34]). There was moderate between study heterogeneity for social cognition outcomes(tau(s)= 0.12) Moderator analyses revealed that IN-OT had a significantly larger effect on high-level social cognition (ie, mentalizing and theory of mind) compared to low-level social cognition (ie, social cue perception) (b = 0.19, 95% CI = [0.05, 0.33]). When restricting our analysis to outcomes for highlevel social cognition, there was a significant effect of IN-OT (SMD = 0.20, 95 % CI = [0.05, 0.33]) but the effect was not robust to sensitivity analyses. The present analysis indicates that IN-OT may have selective effects on high-level social cognition, which provides a more focused target for future studies of IN-OT.