Mortality in people with schizophrenia: a systematic review and meta‐analysis of relative risk and aggravating or attenuating factors

World Psychiatry, Journal Year: 2022, Volume and Issue: 21(2), P. 248 - 271

Published: May 7, 2022

People with schizophrenia die 15‐20 years prematurely. Understanding mortality risk and aggravating/attenuating factors is essential to reduce this gap. We conducted a systematic review random‐effects meta‐analysis of prospective retrospective, nationwide targeted cohort studies assessing in people versus the general population or groups matched for physical comorbidities different psychiatric disorders, also moderators. Primary outcome was all‐cause ratio (RR); key secondary outcomes were due suicide natural causes. Other included any other specific‐cause mortality. Publication bias, subgroup meta‐regression analyses, quality assessment (Newcastle‐Ottawa Scale) conducted. Across 135 spanning from 1957 2021 (schizophrenia: N=4,536,447; controls: N=1,115,600,059; illness N=3,827,955), increased non‐schizophrenia control group (RR=2.52, 95% CI: 2.38‐2.68, n=79), largest first‐episode (RR=7.43, 4.02‐13.75, n=2) incident (i.e., earlier‐phase) (RR=3.52, 3.09‐4.00, n=7) population. Specific‐cause highest injury‐poisoning undetermined non‐natural cause (RR=9.76‐8.42), followed by pneumonia among causes (RR=7.00, 6.79‐7.23), decreasing through infectious endocrine respiratory urogenital diabetes (RR=3 4), alcohol gastrointestinal renal nervous system cardio‐cerebrovascular all (RR=2 3), liver cerebrovascular, breast colon pancreas cancer (RR=1.33 1.96). All‐cause slightly but significantly median study year (beta=0.0009, 0.001‐0.02, p=0.02). Individuals <40 age had suicide‐related compared those ≥40 old, higher percentage females samples. than prevalent (RR=3.52 vs. 2.86, p=0.009). Comorbid substance use disorder (RR=1.62, 1.47‐1.80, n=3). Antipsychotics protective against no antipsychotic (RR=0.71, 0.59‐0.84, n=11), effects second‐generation long‐acting injectable anti­psychotics (SGA‐LAIs) (RR=0.39, 0.27‐0.56, n=3), clozapine (RR=0.43, 0.34‐0.55, LAI (RR=0.47, 0.39‐0.58, n=2), SGA (RR=0.53, 0.44‐0.63, n=4). cause‐related mortality, yet first‐generation antipsychotics (FGAs) associated schizophrenia. Higher number variables used adjust analyses moderated larger natural‐cause risk, more recent antipsychotics. These results indicate that excess several modifiable factors. Targeting comorbid abuse, long‐term maintenance treatment appropriate/earlier SGA‐LAIs could

Language: Английский

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Preventive psychiatry: a blueprint for improving the mental health of young people

World Psychiatry, Journal Year: 2021, Volume and Issue: 20(2), P. 200 - 221

Published: May 18, 2021

Preventive approaches have latterly gained traction for improving mental health in young people. In this paper, we first appraise the conceptual foundations of preventive psychiatry, encompassing public health, Gordon's, US Institute Medicine, World Health Organization, and good frameworks, neurodevelopmentally-sensitive clinical staging models. We then review evidence supporting primary prevention psychotic, bipolar common disorders promotion as potential transformative strategies to reduce incidence these Within indicated approaches, high-risk psychosis paradigm has received most empirical validation, while states are increasingly becoming a focus attention. Selective mostly targeted familial vulnerability non-genetic risk exposures. screening psychological/psychoeducational interventions vulnerable subgroups may improve anxiety/depressive symptoms, but their efficacy reducing psychotic/bipolar/common is unproven. physical exercise anxiety disorders. Universal symptoms not prevent depressive/anxiety disorders, universal targeting school climate or social determinants (demographic, economic, neighbourhood, environmental, social/cultural) hold greatest profile population whole. The approach currently fragmented. leverage knowledge from develop blueprint future research practice psychiatry people: integrating frameworks; advancing multivariable, transdiagnostic, multi-endpoint epidemiological knowledge; synergically preventing infrequent disorders; burden together; implementing stratified/personalized prognosis; establishing evidence-based interventions; developing an ethical framework, through education/training; consolidating cost-effectiveness psychiatry; decreasing inequalities. These goals can only be achieved urgent individual, societal, global level response, which promotes vigorous collaboration across scientific, care, societal governmental sectors much at stake people with emerging

Language: Английский

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Risk and protective factors for mental disorders beyond genetics: an evidence‐based atlas

World Psychiatry, Journal Year: 2021, Volume and Issue: 20(3), P. 417 - 436

Published: Sept. 9, 2021

Decades of research have revealed numerous risk factors for mental disorders beyond genetics, but their consistency and magnitude remain uncer­tain. We conducted a “meta‐umbrella” systematic synthesis umbrella reviews, which are reviews meta‐analyses individual studies, by searching international databases from inception to January 1, 2021. included on non‐purely genetic or protective any ICD/DSM disorders, applying an established classification the credibility evidence: class I (convincing), II (highly suggestive), III (suggestive), IV (weak). Sensitivity analyses were prospective studies test temporality (reverse causation), TRANSD criteria applied transdiagnosticity factors, A Measurement Tool Assess Systematic Reviews (AMSTAR) was employed address quality meta‐analyses. Fourteen eligible retrieved, summarizing 390 1,180 associations between putative disorders. 176 evidence associations, relating 142 risk/protective factors. The most robust (class II, designs) 21. For dementia, they type 2 diabetes mellitus (risk ratio, RR 1.54 2.28), depression (RR 1.65 1.99) low frequency social contacts (RR=1.57). opioid use factor tobacco smoking (odds OR=3.07). non‐organic psychotic clinical high state psychosis (OR=9.32), cannabis (OR=3.90), childhood adversities (OR=2.80). depressive widowhood (RR=5.59), sexual dysfunction (OR=2.71), three (OR=1.99) four‐five (OR=2.06) metabolic physical (OR=1.98) (OR=2.42) abuse, job strain (OR=1.77), obesity (OR=1.35), sleep disturbances (RR=1.92). autism spectrum disorder, maternal overweight pre/during pregnancy (RR=1.28). attention‐deficit/hyperactivity disorder (ADHD), pre‐pregnancy (OR=1.63), during (OR=1.60), (OR=1.28). Only one detected: activity (hazard HR=0.62) Alzheimer’s disease. In all, 32.9% quality, 48.9% medium 18.2% quality. Transdiagnostic I‐III mostly involved in early neurodevelopmental period. evidence‐based atlas key identified this study represents benchmark advancing characterization research, expanding intervention preventive strategies

Language: Английский

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Major depressive disorder

Nature Reviews Disease Primers, Journal Year: 2023, Volume and Issue: 9(1)

Published: Aug. 24, 2023

Language: Английский

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Diet and the Microbiota–Gut–Brain Axis: Sowing the Seeds of Good Mental Health

Advances in Nutrition, Journal Year: 2020, Volume and Issue: 12(4), P. 1239 - 1285

Published: Dec. 22, 2020

Language: Английский

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The Coronavirus Health and Impact Survey (CRISIS) reveals reproducible correlates of pandemic-related mood states across the Atlantic

Scientific Reports, Journal Year: 2021, Volume and Issue: 11(1)

Published: April 14, 2021

The COVID-19 pandemic and its social economic consequences have had adverse impacts on physical mental health worldwide exposed all segments of the population to protracted uncertainty daily disruptions. CoRonavIruS Impact Survey (CRISIS) was developed for use as an easy implement robust questionnaire covering key domains relevant distress resilience during pandemic. Ongoing studies using CRISIS include international COVID-related ill conducted different phases follow-up cohorts characterized before COVID In current work, we demonstrate feasibility, psychometric structure, construct validity this survey. We then show that pre-existing mood states, perceived risk, lifestyle changes are strongly associated with negative states in samples adults parents reporting their children US UK. These findings highly reproducible find a high degree consistency power these factors predict

Language: Английский

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Mobile phone-based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials

PLOS Digital Health, Journal Year: 2022, Volume and Issue: 1(1), P. e0000002 - e0000002

Published: Jan. 18, 2022

Mobile phone-based interventions have been proposed as a means for reducing the burden of disease associated with mental illness. While numerous randomized controlled trials and meta-analyses investigated this possibility, evidence remains unclear. We conducted systematic meta-review examining mobile tested in trials. synthesized results from 14 representing 145 47,940 participants. identified 34 effect sizes unique pairings participants, intervention, comparisons, outcome (PICO) graded strength using umbrella review methodology. failed to find convincing efficacy (i.e., n > 1000, p < 10-6, I 2 50%, absence publication bias); bias was rarely assessed representative sizes. Eight provided highly suggestive 10-6), including smartphone outperforming inactive controls on measures psychological symptoms quality life (ds = 0.32 0.47) text message-based non-specific active smoking cessation 0.31 0.19, respectively). The magnitude effects tended diminish comparison conditions became more rigorous active, specific). Four evidence, weak eight were non-significant. Despite substantial heterogeneity, no moderators identified. Adverse not reported. Taken together, support potential highlight key directions guide providers, policy makers, clinical trialists, meta-analysts working area.

Language: Английский

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Physical activity, exercise, and mental disorders: it is time to move on

Trends in Psychiatry and Psychotherapy, Journal Year: 2021, Volume and Issue: unknown

Published: Jan. 1, 2021

Introduction: Physical activity, conceptualized as any bodily movement that results in energy expenditure, and its structured form, exercise, play an important role public health, preventing treating a wide range of physical conditions, including metabolic cardiovascular diseases obesity.Objective: This article aims to provide brief overview summary the evidence on: 1) preventive effects activity on mental disorders; 2) promoting health people with 3) exercise strategy manage symptoms 4) challenges barriers faced when implementing clinical practice.Methods: was narrative review.Results: Compelling has demonstrated can also prevent common disorders, such depression anxiety have multiple beneficial disorders.This body been incorporated national international guidelines over last decades, which recommended inclusion therapeutic approaches for mainly schizophrenia.Nonetheless, implementation into practice slow, probably due associated both patients professionals. Conclusion:Increases levels populations are likely reduce burden.Exercise interventions should be routine care disorders benefits outcomes.A multidisciplinary approach is needed overcome enhance adherence benefits.

Language: Английский

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Incidence, prevalence, and global burden of schizophrenia - data, with critical appraisal, from the Global Burden of Disease (GBD) 2019

Molecular Psychiatry, Journal Year: 2023, Volume and Issue: 28(12), P. 5319 - 5327

Published: July 27, 2023

Language: Английский

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Mental health care for older adults: recent advances and new directions in clinical practice and research

World Psychiatry, Journal Year: 2022, Volume and Issue: 21(3), P. 336 - 363

Published: Sept. 8, 2022

The world's population is aging, bringing about an ever-greater burden of mental disorders in older adults. Given multimorbidities, the health care these people and their family caregivers labor-intensive. At same time, ageism a big problem for people, with without disorders. Positive elements such as resilience, wisdom prosocial behaviors, need to be highlighted promoted, both combat stigma help protect improve positive psychiatry aging not oxymoron, but scientific construct strongly informed by research evidence. We champion broader concept geriatric - one that encompasses well illness. In present paper, we address issues context four are greatest source years lived disability: neurocognitive disorders, major depression, schizophrenia, substance use emphasize implementation multidisciplinary team care, comprehensive assessment, clinical management, intensive outreach, coordination mental, physical social services. also underscore further into moderators mediators treatment response variability. Because optimal adults patient-focused family-centered, call enhancing well-being caregivers. To optimize safety efficacy pharmacotherapy, attention metabolic, cardiovascular neurological tolerability much needed, together development testing medications reduce risk suicide. normal cognitive antidote catalyst change way think per se late-life more specifically. It this provide directions future research.

Language: Английский

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