The prenatal and early-life periods pose a crucial neurodevelopmental window whereby disruptions to the intestinal microbiota and the developing brain may have adverse impacts. As antibiotics affect the human intestinal microbiome, it follows that early-life antibiotic exposure may be associated with later-life psychiatric or neurocognitive outcomes.

To explore the association between early-life (in utero and early childhood (age 0–2 years)) antibiotic exposure and the subsequent risk of psychiatric and neurocognitive outcomes.

A search was conducted using Medline, PsychINFO and Excerpta Medica databases on 20 November 2023. Risk of bias was assessed using the Newcastle-Ottawa scale, and certainty was assessed using the grading of recommendations, assessment, development and evaluation (GRADE) certainty assessment.

Thirty studies were included (n = 7 047 853 participants). Associations were observed between in utero antibiotic exposure and later development of autism spectrum disorder (ASD) (odds ratio 1.09, 95% CI: 1.02–1.16) and attention-deficit hyperactivity disorder (ADHD) (odds ratio 1.19, 95% CI: 1.11–1.27) and early-childhood exposure and later development of ASD (odds ratio 1.19, 95% CI: 1.01–1.40), ADHD (odds ratio 1.33, 95% CI: 1.20–1.48) and major depressive disorder (MDD) (odds ratio 1.29, 95% CI: 1.04–1.60). However, studies that used sibling control groups showed no significant association between early-life exposure and ASD or ADHD. No studies in MDD used sibling controls. Using the GRADE certainty assessment, all meta-analyses but one were rated very low certainty, largely owing to methodological and statistical heterogeneity.

While there was weak evidence for associations between antibiotic use in early-life and later neurodevelopmental outcomes, these were attenuated in sibling-controlled subgroup analyses. Thus, associations may be explained by genetic and familial confounding, and studies failing to utilise sibling-control groups must be interpreted with caution. PROSPERO ID: CRD42022304128

Family members of people with mental illness (MI) may experience a host of psychological adversities such as increased stress, burden, and reduced wellbeing. However, relatively little is known about siblings. This study aimed to characterise the experience of distress (viz. depressive and anxiety symptoms), burden, and wellbeing in siblings of people with MI.

Studies reporting on quantitative measures of depression, anxiety, burden, or wellbeing in siblings; and/or qualitative findings on siblings’ experience were eligible. The literature search was conducted up until 20th October 2022.

Sixty-two studies comprising data from 3744 siblings were included. The pooled mean percentage of depressive symptoms fell in the mild range at 15.71 (k = 28, N = 2187, 95% CI 12.99–18.43) and anxiety symptoms fell in the minimal range at 22.45 (k = 16, N = 1122, 95% CI 17.09–27.80). Moderator analyses indicate that siblings of people with a schizophrenia spectrum disorder experience greater depressive symptoms than siblings of people with other types of MI (β = −16.38, p < 0.001). Qualitative findings suggest that individuals may be particularly vulnerable during their siblings’ illness onset and times of relapse. Limited communication, confusion about MI, and the need to compensate may contribute to siblings’ distress and/or burden. Siblings’ experience of wellbeing and caregiving were closely related.

This review highlights the complex psychological experience of siblings and the need for greater research and clinical support for this important yet often overlooked cohort.

Characterising meat consumption in Switzerland across socio-demographic, lifestyle and anthropometric groups.

Representative national data from the menuCH survey (two 24-hour dietary recalls, anthropometric measurements and a lifestyle questionnaire) were used to analyse the total average daily intake of meat and main meat categories. Energy-standardised average intake (g/1000 kcal) was calculated and its association with 12 socio-demographic, lifestyle and anthropometric variables was investigated using multivariable linear regression.

Switzerland.

Totally, 2057 participants aged 18–75 years.

Average total meat intake was 109 g/d, which included 43 g/d of processed meat, 37 g/d of red meat and 27 g/d of white meat. Energy-standardised meat intake was highest for men, the Italian-language region and the youngest age group (18–29 years). Regression results showed significantly lower total meat and red meat consumption (g/1000 kcal) for women than men. However, there were no sex-specific differences for white meat. Total meat and white meat consumption were positively associated with the 18–29 age group, compared with 30–44 years, non-Swiss compared with Swiss participants and one-parent families with children compared with couples without children. Consumption of all categories of meat showed positive associations for BMI > 25 kg/m2 compared with BMI 18·5–25 kg/m2 and for French- and Italian-language regions compared with German-language region.

The current study reveals that there are significant differences in the amounts and types of meat consumed in Switzerland, suggesting that evidence-based risks and benefits of these categories need to be emphasised more in meat consumption recommendations.