SUMMARYThe aim of this study was to compare the shortterm clinical efficacy and safety of risperidone with haloperidol and placebo. A meta-analysis of seven published randomized double-blind controlled trials was carried out. Study quality was assessed. The proportion of patients failing to reach at least 20% improvement on the positive and negative syndrome scale (P ANSS) or brief psychiatric rating scale (BPRS), the proportion of patients discontinuing treatment because of adverse effects and the number of patients who needed antiparkinsonian medication were abstracted for use as outcome measures.Treatment failure was present in 50% of risperidone-treated patients compared to 66% in those treated with haloperidol and 83% in those treated with placebo. It would be necessary to treat 11 patients with risperidone to prevent one treatment failure in those patients treated with haloperidol (Odds ratio (0R)=0·74, 95% CI of 0·58-0·94, P=0·02). Pooling of the three multicentre trials which included placebo as a treatment arm, showed that one in three patients treated with risperidone 4-16 mg/day (OR=0·22, 95% CI of 0·13-o·39, P<0·00001) and one in six treated with haloperidol 1o-20 mg/day (OR=0·44, 95% CI of 0·22-o·84, P=0·02) would derive significant benefit. Moreover, there was a highly significant greater need for anticholinergic medication due
Childhood maltreatment is a key predictor of mental health problems across the life span. Yet, how maltreatment types independently and jointly influence the risk for psychiatric problems remains unclear. The aim of the study was two-fold: first, to replicate recent findings regarding the impact of maltreatment types on youth psychiatric symptoms, based on a Brazilian sample of high-risk adolescents (n = 347; age range = 11-17 yrs), and second, to extend existing findings by examining whether this relationship is mediated by bullying victimization and/or perpetration. Measures included self-report ratings of childhood maltreatment and peer victimization, as well as multi-informant reports of internalizing and externalizing symptoms. Consistent with prior research, we found that: (i) maltreatment types often co-occurred; (ii) there was a linear association between number of maltreatment types experienced and symptom severity (i.e. cumulative effect); and (iii) emotional abuse emerged as the most consistent independent predictor of poor mental health across domains, raters, and gender. Additionally, this study extends previous findings by showing that the influence of maltreatment on psychiatric outcomes is partially mediated by peer victimization, but not by bullying perpetration. In conclusion, these findings expand our understanding of the heterogeneity in individual responses to maltreatment as well as highlighting emotional abuse as an important predictor of poor mental health.
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