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Impact of mental di...
Impact of mental disorders on clinical outcomes of physical diseases: an umbrella review assessing population attributable fraction and generalized impact fraction
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- Dragioti, Elena (författare)
- Linköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Region Östergötland, Smärt och rehabiliteringscentrum,Univ Ioannina, Greece
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- Radua, Joaquim (författare)
- Kings Coll London, England; Univ Barcelona, Spain; Karolinska Inst, Sweden
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- Solmi, Marco (författare)
- Kings Coll London, England; Univ Ottawa, Canada; Ottawa Hosp, Canada; Univ Southampton, England; Charite, Germany
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- Gosling, Corentin J. (författare)
- Univ Southampton, England; Paris Nanterre Univ, France; Univ Paris Cite, France
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- Oliver, Dominic (författare)
- Kings Coll London, England; Univ Oxford, England
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- Lascialfari, Filippo (författare)
- Univ Pavia, Italy
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- Ahmed, Muhammad (författare)
- Kings Coll London, England
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- Cortese, Samuele (författare)
- Univ Southampton, England; Univ Southampton, England; Solent NHS Trust, England; Univ Nottingham, England
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- Estrade, Andres (författare)
- Kings Coll London, England
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- Arrondo, Gonzalo (författare)
- Univ Southampton, England; NYU Langone, NY USA
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- Gouva, Mary (författare)
- Univ Ioannina, Greece
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- Fornaro, Michele (författare)
- Univ Navarra, Spain
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- Batiridou, Agapi (författare)
- Univ Ioannina, Greece
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- Dimou, Konstantina (författare)
- Univ Ioannina, Greece
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- Tsartsalis, Dimitrios (författare)
- Federico II Univ Naples, Italy
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- Carvalho, Andre F. (författare)
- Hippokrateion Hosp, Greece
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- Shin, Jae Il (författare)
- Deakin Univ, Australia; Barwon Hlth, Australia; Yonsei Univ, South Korea
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- Berk, Michael (författare)
- Hippokrateion Hosp, Greece
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- Stringhini, Silvia (författare)
- Severance Childrens Hosp, South Korea; Geneva Univ Hosp, Switzerland; Univ Lausanne, Switzerland; Univ Geneva, Switzerland
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- Correll, Christoph U. (författare)
- Charite, Germany; Zucker Hillside Hosp, NY USA
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- Fusar-Poli, Paolo (författare)
- Kings Coll London, England; Univ Pavia, Italy
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(creator_code:org_t)
- 2023-01-14
- 2023
- Engelska.
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Ingår i: World Psychiatry. - : WILEY. - 1723-8617 .- 2051-5545. ; 22:1, s. 86-104
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Empirical evidence indicates a significant bidirectional association between mental disorders and physical diseases, but the prospective impact of men-tal disorders on clinical outcomes of physical diseases has not been comprehensively outlined. In this PRISMA- and COSMOS-E-compliant umbrella review, we searched PubMed, PsycINFO, Embase, and Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, up to March 15, 2022, to identify systematic reviews with meta-analysis that examined the prospective association between any mental disorder and clinical outcomes of physical diseases. Primary outcomes were disease-specific mortality and all-cause mortality. Secondary outcomes were disease-specific incidence, functioning and/or disability, symptom severity, quality of life, recurrence or progression, major cardiac events, and treatment-related outcomes. Additional inclusion criteria were further applied to primary studies. Random effect models were employed, along with I-2 statistic, 95% prediction intervals, small-study effects test, excess significance bias test, and risk of bias (ROBIS) assessment. Associations were classified into five credibility classes of evidence (I to IV and non-significant) according to established criteria, complemented by sensitivity and subgroup analyses to examine the robustness of the main analysis. Statistical analysis was performed using a new package for conducting umbrella reviews (). Population attributable fraction (PAF) and generalized impact fraction (GIF) were then calculated for class I-III associations. Forty-seven systematic reviews with meta-analysis, encompassing 251 non-overlapping primary studies and reporting 74 associations, were included (68% were at low risk of bias at the ROBIS assessment). Altogether, 43 primary outcomes (disease-specific mortality: n=17; all-cause mortality: n=26) and 31 secondary outcomes were investigated. Although 72% of associations were statistically significant (p<0.05), only two showed convincing (class I) evidence: that between depressive disorders and all-cause mortality in patients with heart failure (hazard ratio, HR=1.44, 95% CI: 1.26-1.65), and that between schizophrenia and cardiovascular mortality in patients with cardiovascular diseases (risk ratio, RR=1.54, 95% CI: 1.36-1.75). Six associations showed highly suggestive (class II) evidence: those between depressive disorders and all-cause mortality in patients with diabetes mellitus (HR=2.84, 95% CI: 2.00-4.03) and with kidney failure (HR=1.41, 95% CI: 1.31-1.51); that between depressive disorders and major cardiac events in patients with myocardial infarction (odds ratio, OR=1.52, 95% CI: 1.36-1.70); that between depressive disorders and dementia in patients with diabetes mellitus (HR=2.11, 95% CI: 1.77-2.52); that between alcohol use disorder and decompensated liver cirrhosis in patients with hepatitis C (RR=3.15, 95% CI: 2.87-3.46); and that between schizophrenia and cancer mortality in patients with cancer (standardized mean ratio, SMR=1.74, 95% CI: 1.41-2.15). Sensitivity/subgroup analyses confirmed these results. The largest PAFs were 30.56% (95% CI: 27.67-33.49) for alcohol use disorder and decompensated liver cirrhosis in patients with hepatitis C, 26.81% (95% CI: 16.61-37.67) for depressive disorders and all-cause mortality in patients with diabetes mellitus, 13.68% (95% CI: 9.87-17. 58) for depressive disorders and major cardiac events in patients with myocardial infarction, 11.99% (95% CI: 8.29-15.84) for schizophrenia and cardiovascular mortality in patients with cardiovascular diseases, and 11.59% (95% CI: 9.09-14.14) for depressive disorders and all-cause mortality in patients with kidney failure. The GIFs confirmed the preventive capacity of these associations. This umbrella review demonstrates that mental disorders increase the risk of a poor clinical outcome in several physical diseases. Prevention targeting mental disorders - particularly alcohol use disorders, depressive disorders, and schizophrenia - can reduce the incidence of adverse clinical outcomes in people with physical diseases. These findings can inform clinical practice and trans-speciality preventive approaches cutting across psychiatric and somatic medicine.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
Nyckelord
- Mental disorders; physical diseases; outcomes; disease-specific mortality; all-cause mortality; trans-speciality prevention
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- Av författaren/redakt...
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Dragioti, Elena
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Radua, Joaquim
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Solmi, Marco
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Gosling, Corenti ...
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Oliver, Dominic
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Lascialfari, Fil ...
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visa fler...
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Ahmed, Muhammad
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Cortese, Samuele
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Estrade, Andres
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Arrondo, Gonzalo
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Gouva, Mary
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Fornaro, Michele
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Batiridou, Agapi
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Dimou, Konstanti ...
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Tsartsalis, Dimi ...
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Carvalho, Andre ...
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Shin, Jae Il
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Berk, Michael
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Stringhini, Silv ...
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Correll, Christo ...
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Fusar-Poli, Paol ...
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Psykiatri
- Artiklar i publikationen
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World Psychiatry
- Av lärosätet
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Linköpings universitet
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Karolinska Institutet