Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management

World Psychiatry, Год журнала: 2023, Номер 22(3), С. 366 - 387

Опубликована: Сен. 15, 2023

Populations with common physical diseases – such as cardiovascular diseases, cancer and neurodegenerative disorders experience substantially higher rates of major depressive disorder (MDD) than the general population. On other hand, people living MDD have a greater risk for many diseases. This high level comorbidity is associated worse outcomes, reduced adherence to treatment, increased mortality, health care utilization costs. Comorbidity can also result in range clinical challenges, more complicated therapeutic alliance, issues pertaining adaptive behaviors, drug‐drug interactions adverse events induced by medications used mental disorders. Potential explanations prevalence above involve shared genetic biological pathways. These latter include inflammation, gut microbiome, mitochondrial function energy metabolism, hypothalamic‐pituitary‐adrenal axis dysregulation, brain structure function. Furthermore, several antecedents related social factors (e.g., socioeconomic status), lifestyle variables activity, diet, sleep), stressful live childhood trauma). Pharmacotherapies psychotherapies are effective treatments comorbid MDD, introduction interventions well collaborative models digital technologies provide promising strategies improving management. paper aims detailed overview epidemiology specific including bidirectional risk; pathways potentially implicated pathogenesis diseases; socio‐environmental that serve both protective factors; management prevention treatment. We conclude future directions emerging research optimal

Язык: Английский

---

Outcomes in people with eating disorders: a transdiagnostic and disorder‐specific systematic review, meta‐analysis and multivariable meta‐regression analysis

World Psychiatry, Год журнала: 2024, Номер 23(1), С. 124 - 138

Опубликована: Янв. 12, 2024

Eating disorders (EDs) are known to be associated with high mortality and often chronic severe course, but a recent comprehensive systematic review of their outcomes is currently missing. In the present meta-analysis, we examined cohort studies clinical trials published between 1980 2021 that reported, for DSM/ICD-defined EDs, overall ED (i.e., recovery, improvement relapse, all-cause ED-related hospitalization, chronicity); same related purging, binge eating body weight status; as well mortality. We included 415 (N=88,372, mean age: 25.7±6.9 years, females: 72.4%, follow-up: 38.3±76.5 months), conducted in persons anorexia nervosa (AN), bulimia (BN), disorder (BED), other specified feeding (OSFED), and/or mixed from all continents except Africa. EDs pooled together, recovery occurred 46% patients (95% CI: 44-49, n=283, 44.9±62.8 months, no significant ED-group difference). The rate was 42% at <2 43% 2 <4 54% 4 <6 59% 6 <8 64% 8 <10 67% ≥10 years. Overall chronicity 25% 23-29, n=170, 59.3±71.2 33% 40% 23% 12% 18% Mortality 0.4% 0.2-0.7, n=214, 72.2±117.7 Considering observational studies, 5.2 deaths/1,000 person-years 4.4-6.1, n=167, 88.7±120.5 months; difference among EDs: p<0.01, range: 8.2 3.4 BN). Hospitalization 26% 18-36, n=18, 43.2±41.6 p<0.001, 32% AN 4% Regarding diagnostic migration, 8% migrated BN 16% OSFED; 2% AN, 5% BED, 19% 9% BED 7% OSFED 10% BN. Children/adolescents had more favorable across within than adults. Self-injurious behaviors were lower rates EDs. A higher socio-demographic index moderated countries. Specific treatments family-based therapy, cognitive-behavioral therapy (CBT), psychodynamic nutritional interventions AN; self-help, CBT, dialectical behavioral (DBT), pharmacological BN; interventions, DBT BED; CBT OSFED. treatment waiting list These results should inform future research, practice health service organization

Язык: Английский

---

Impact of air pollution and climate change on mental health outcomes: an umbrella review of global evidence

World Psychiatry, Год журнала: 2024, Номер 23(2), С. 244 - 256

Опубликована: Май 10, 2024

The impact of air pollution and climate change on mental health has recently raised strong concerns. However, a comprehensive overview analyzing the existing evidence while addressing relevant biases is lacking. This umbrella review systematically searched PubMed/Medline, Scopus PsycINFO databases (up to June 26, 2023) for any systematic with meta-analysis investigating association or outcomes. We used R metaumbrella package calculate stratify credibility according criteria (i.e., convincing, highly suggestive, weak) that address several biases, complemented by sensitivity analyses. included 32 reviews examined 284 individual studies 237 associations exposures hazards Most (n=195, 82.3%) involved pollution, rest (n=42, 17.7%) regarded (mostly focusing temperature: n=35, 14.8%). Mental outcomes in most (n=185, 78.1%) disorders, followed suicidal behavior (n=29, 12.4%), access care services (n=9, 3.7%), disorders-related symptomatology (n=8, 3.3%), multiple categories together (n=6, 2.5%). Twelve (5.0%) achieved convincing (class I) suggestive II) evidence. Regarding there was between long-term exposure solvents higher incidence dementia cognitive impairment (odds ratio, OR=1.139), some pollutants risk disorders (higher high vs. low levels carbon monoxide, CO: OR=1.587; vascular per 1 μg/m

Язык: Английский

---

Clinical effectiveness of the psychological therapy Mental Health Intervention for Children with Epilepsy in addition to usual care compared with assessment-enhanced usual care alone: a multicentre, randomised controlled clinical trial in the UK

The Lancet, Год журнала: 2024, Номер 403(10433), С. 1254 - 1266

Опубликована: Март 1, 2024

BackgroundMental health difficulties are common in children and young people with chronic conditions, but many of those need do not access evidence-based psychological treatments. The study aim was to evaluate the clinical effectiveness integrated mental treatment for epilepsy, a condition known be associated particularly high rate co-occurring difficulties.MethodsWe conducted parallel group, multicentre, open-label, randomised controlled trial participants aged 3–18 years, attending epilepsy clinics across England Northern Ireland who met diagnostic criteria disorder. Participants were (1:1; using an independent web-based system) receive Mental Health Intervention Children Epilepsy (MICE) addition usual care, or assessment-enhanced care alone (control). both groups received full assessment. MICE modular intervention designed treat conditions approaches such as cognitive behaviour therapy behavioural parenting strategies. Usual disorders varied by site typically included referral appropriate services. Participants, along their caregivers, clinicians masked allocation statisticians until point analysis. primary outcome, analysed modified intention-to-treat, parent-report Strengths Difficulties Questionnaire (SDQ) at 6 months post-randomisation. is complete registered ISRCTN (57823197).Findings1401 potentially deemed eligible inclusion. Following exclusion 531 people, 870 assessed eligibility completed SDQ, 480 caregivers provided consent inclusion between May 20, 2019, Jan 31, 2022. Between Aug 28, Feb 21, 2022, 334 (mean ages 10·5 years [SD 3·6] group vs 10·3 [4·0] control baseline) randomly assigned minimisation balanced age, disorder, diagnosis intellectual disability, autistic spectrum disorder baseline. 168 (50%) female 166 male. group. At months, mean SDQ 148 17·6 (SD 6·3) 19·6 (6·1) adjusted effect –1·7 (95% CI –2·8 –0·5; p=0·0040; Cohen's d, 0·3). 14 (8%) patients experienced least one serious adverse event compared 24 (14%) 68% percent events (50 events) admission due seizures.InterpretationMICE superior improving symptoms emotional disorders. therefore shows that comorbidities can effectively safely treated variety clinicians, utilising context disability autism. evidence from this suggests model should fully embedded services serves other people.FundingUK National Institute Research Programme Grants Applied programme UK Endeavour Project Grant.

Язык: Английский

---

The prevalence of mental health issues among nursing students: An umbrella review synthesis of meta-analytic evidence

International Journal of Nursing Studies, Год журнала: 2025, Номер 163, С. 104993 - 104993

Опубликована: Янв. 7, 2025

Язык: Английский

---

Transdiagnostic risk of mental disorders in offspring of affected parents: a meta‐analysis of family high‐risk and registry studies

World Psychiatry, Год журнала: 2023, Номер 22(3), С. 433 - 448

Опубликована: Сен. 15, 2023

The offspring of parents with mental disorders are at increased risk for developing themselves. to may extend transdiagnostically other than those present in the parents. literature on this topic is vast but mixed. To inform targeted prevention and genetic counseling, we performed a comprehensive, PRISMA 2020-compliant meta-analysis. We systematically searched published up September 2022 retrieve original family high-risk registry studies reporting any type disorder. random-effects meta-analyses relative (risk ratio, RR) absolute (lifetime, age assessment) disorders, defined according ICD or DSM. Cumulative incidence by was determined using meta-analytic Kaplan-Meier curves. measured heterogeneity I2 statistic, bias Quality In Prognosis Studies (QUIPS) tool. Sensitivity analyses addressed impact study design (family vs. registry) specific transdiagnostic risks. Transdiagnosticity appraised TRANSD criteria. identified 211 independent that reported data 3,172,115 psychotic, bipolar, depressive, disruptive, attention-deficit/hyperactivity, anxiety, substance use, eating, obsessive-compulsive, borderline personality 20,428,575 control offspring. RR lifetime disorder were 3.0 55% anxiety disorders; 2.6 17% psychosis; 2.1 bipolar disorder; 1.9 51% depressive 1.5 38% use disorders. offspring's same diagnosed their parent 8.4 32% attention-deficit/hyperactivity 5.8 8% 5.1 5% 2.8 9% 2.3 14% 1% eating 2.2 31% There 37 significant associations between parental different psychosis, disorder, onset emerged 16, 5 6 years, cumulated 3%, 19% 24% 18; 8%, 36% 46% 28. Heterogeneity ranged from 0 0.98, 96% high bias. restricted prospective confirmed pattern findings similar RR, greater risks compared all types. This demonstrates global, level affected have strongly elevated as well parent. suggest range should be considered candidates primary prevention.

Язык: Английский

---

Regional differences in mortality risk and in attenuating or aggravating factors in schizophrenia: A systematic review and meta-analysis

European Neuropsychopharmacology, Год журнала: 2024, Номер 80, С. 55 - 69

Опубликована: Фев. 17, 2024

Язык: Английский

---

Loneliness, social isolation, and living alone: a comprehensive systematic review, meta-analysis, and meta-regression of mortality risks in older adults

Aging Clinical and Experimental Research, Год журнала: 2025, Номер 37(1)

Опубликована: Янв. 21, 2025

Abstract Loneliness, social isolation, and living alone are significant risk factors for mortality, particularly in older adults. This systematic review meta-analysis aimed to quantify their associations with all-cause cause-specific mortality adults, broadening previous research by including more factors. Comprehensive searches were conducted PubMed, APA PsycINFO, CINAHL until December 31, 2023, following PRISMA 2020 MOOSE guidelines. Studies included prospective cohort or longitudinal studies examining the relationship between loneliness, alone, mortality. Quality was assessed using Newcastle-Ottawa Scale. Meta-analyses used random-effects models Restricted Maximum Likelihood method. Subgroup meta-regression analyses explored relationships further. Of 11,964 identified studies, 86 met inclusion criteria. Loneliness associated increased (HR 1.14, 95% CI 1.10–1.18), substantial heterogeneity (I² = 84.0%). Similar found isolation 1.35, 1.27–1.43) 1.21, 1.13–1.30). revealed variations based on like sex, age, region, chronic diseases, study quality. Meta-regression longer follow-up, female validated network indices, adjustments cognitive function, quality as predictors of risks. These findings highlight need public health interventions address these improve outcomes However, further is needed due variability across studies. Also studying cumulative effect risks will be considerable interest.

Язык: Английский

---

Two Long-Acting Antipsychotics in a Patient with Treatment-Resistant Schizophrenia: A Case Report

Clinics and Practice, Год журнала: 2025, Номер 15(3), С. 55 - 55

Опубликована: Март 10, 2025

Treatment-resistant schizophrenia (TRS) poses significant therapeutic challenges due to persistent symptoms, poor adherence, and high relapse rates. Long-acting injectable (LAI) antipsychotics offer a promising approach, yet limited evidence exists regarding the combination of two LAI formulations. We report case 62-year-old woman with TRS, characterized by recurrent hospitalizations inadequate responses oral monotherapy treatments. During her latest hospitalization, she received alternating intramuscular administrations haloperidol decanoate (100 mg/28 days) aripiprazole (400 days). The dual strategy resulted in marked improvement psychotic functional recovery, treatment no reported side effects. This highlights potential benefits therapy managing particularly patients non-adherence medications or response standard Additional studies are required evaluate long-term effectiveness safety this innovative approach.

Язык: Английский

---

Physical activity, suicidal ideation, suicide attempt and death among individuals with mental or other medical disorders: A systematic review of observational studies

Neuroscience & Biobehavioral Reviews, Год журнала: 2024, Номер 158, С. 105547 - 105547

Опубликована: Янв. 21, 2024

A growing body of research has demonstrated the potential role for physical activity as an intervention across mental and other medical disorders. However, association between suicidal ideation, attempts, deaths not been systematically appraised in clinical samples. We conducted a PRISMA 2020-compliant systematic review searching MEDLINE, EMBASE, PsycINFO observational studies investigating influence on behavior up to December 6, 2023. Of 116 eligible full-text studies, seven (n = 141691) were included. Depression was most frequently studied condition (43%, k 3), followed by chronic pain common (29%, 2). Two case-control examined suicide attempts found reduced frequency such attempts. examining ideation (k 3) or 2), no consistent associations with observed. Overall, our that may be linked lower non-prospective involving individuals

Язык: Английский

---