title: Prolactin and hostility in hospitalised patients and healthy women: A systematic review and meta-analysis.
abstract: The aim of this systematic review and meta-analysis was to assess any difference in the self-ratings of hostility in mentally healthy women with different levels of prolactin (PRL). Electronic databases (PubMed, MEDLINE, EMBASE and the Cochrane Library) were searched up to 2nd July 2012 for published literature comparing hostility levels in women with different levels of PRL. Keyword pairs ('prolactin' and 'aggression', 'prolactin' and 'hostil*', 'prolactin' and 'anger', and 'prolactin' and 'angry') were entered simultaneously. From 1065 resulting titles, and one unpublished study, 214 articles underwent full-text review by authors JB and EM. Studies were selected based on clinical relevance. Eight comparative studies consisting of 242 female patients with high PRL levels, 207 female patients with normal PRL levels and 127 healthy controls with normal PRL levels were included. Data were analysed using the inverse variance method with a random-effects model. Analysis revealed significantly higher hostility in patients with high PRL compared with that in healthy control women (Z = 1.94, p < 0.05; Hedges' g = 0.72; 95% confidence interval [CI]: -0.01-1.45), significantly higher hostility in patient controls compared with that in healthy controls (Z = 1.94, p < 0.05; Hedges' g = 0.47; 95% CI: 0.00-0.94) and non-significantly higher hostility levels in patients with high PRL compared with that in patients with normal PRL levels (Z = 1.45, p < 0.15; Hedges' g = 0.38; 95% CI: -0.13-0.89). In this meta-analysis, hostility appears to be accounted for partly by PRL levels and also partly by patient status, perhaps due to the stress of being a patient. Methodological considerations and implications for patient care are discussed.
authors.affiliation: a Institute for Women's Health, University College London Medical School , London , UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Barry
authors.affiliation: b Department of Neurology , University of Pennsylvania Perelman School of Medicine , Philadelphia , PA , USA.
authors.forename: E
authors.initials: E
authors.lastname: Moran
authors.affiliation: c Department of Clinical Biochemistry , Royal Free London Hospital , London , UK.
authors.forename: M
authors.initials: M
authors.lastname: Thomas
authors.affiliation: a Institute for Women's Health, University College London Medical School , London , UK.
authors.forename: P J
authors.initials: PJ
authors.lastname: Hardiman
mesh_terms: D005260:Female; D006791:Hostility; D006801:Humans; D007297:Inpatients; D011388:Prolactin / Q000097:blood*
chemical_list: D011388:Prolactin
keywords: Hostility; meta-analysis; patient care; prolactin; review