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Kandola A, Lewis G, Osborn DPJ, Stubbs B, Hayes JF. Device-measured sedentary behaviour and anxiety symptoms during adolescence: a 6-year prospective cohort study. Psychol Med 2022; 52:2962-2971. [PMID: 33336634 PMCID: PMC9693656 DOI: 10.1017/s0033291720004948] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/22/2020] [Accepted: 11/25/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Sedentary behaviour is potentially a modifiable risk factor for anxiety disorders, a major source of global disability that typically starts during adolescence. This is the first prospective study of associations between repeated, device-based measures of sedentary behaviour and anxiety symptoms in adolescents. METHODS A UK cohort with 4257 adolescents aged 12 at baseline (56% female). Main exposures were sedentary behaviour and physical activity measured using accelerometers for 7-days at ages 12, 14, and 16. Primary outcome was anxiety symptom scores at age 18 from a Clinical Interview Schedule-Revised. We used adjusted negative binomial regression and iso-temporal substitution methods to analyse the data. RESULTS We found a positive association between sedentary behaviour at ages 12, 14, and 16, with anxiety symptoms at age 18, independent of total physical activity volume. Theoretically replacing an hour of daily sedentary behaviour for light activity at ages 12, 14, and 16, was associated with lower anxiety symptoms by age 18 by 15.9% (95% CI 8.7-22.4), 12.1% (95% CI 3.4-20.1), and 14.7% (95% CI 4-24.2), respectively. Whereas, theoretically replacing an hour of sedentary behaviour with moderate-to-vigorous physical activity was not associated with differences in anxiety symptoms. These results were robust to a series of sensitivity analyses. CONCLUSION Sedentary behaviour is a possible risk factor for increasing anxiety symptoms during adolescence, independent of total physical activity volume. Instead of focusing on moderate-to-vigorous activity, replacing daily sedentary behaviour with light activity during adolescence could be a more suitable method of reducing future anxiety symptoms.
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Affiliation(s)
- A. Kandola
- Division of Psychiatry, University College London, London, UK
| | - G. Lewis
- Division of Psychiatry, University College London, London, UK
| | - D. P. J. Osborn
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - B. Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Physiotherapy Department, South London, and Maudsley National Health Services Foundation Trust, London, UK
| | - J. F. Hayes
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
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2
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Jarde A, Romano E, Afaq S, Elsony A, Lin Y, Huque R, Elsey H, Siddiqi K, Stubbs B, Siddiqi N. Prevalence and risks of tuberculosis multimorbidity in low-income and middle-income countries: a meta-review. BMJ Open 2022; 12:e060906. [PMID: 36175100 PMCID: PMC9528681 DOI: 10.1136/bmjopen-2022-060906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Co-occurrence of tuberculosis (TB) with other chronic conditions (TB multimorbidity) increases complexity of management and adversely affects health outcomes. We aimed to map the prevalence of the co-occurrence of one or more chronic conditions in people with TB and associated health risks by systematically reviewing previously published systematic reviews. DESIGN Systematic review of systematic reviews (meta-review). SETTING Low-income and middle-income countries (LMICs). PAPERS We searched in Medline, Embase, PsycINFO, Social Sciences Citation Index, Science Citation Index, Emerging Sources Citation Index and Conference Proceedings Citation Index, and the WHO Global Index Medicus from inception to 23 October 2020, contacted authors and reviewed reference lists. Pairs of independent reviewers screened titles, abstracts and full texts, extracted data and assessed the included reviews' quality (AMSTAR2). We included systematic reviews reporting data for people in LMICs with TB multimorbidity and synthesised them narratively. We excluded reviews focused on children or specific subgroups (eg, incarcerated people). PRIMARY AND SECONDARY OUTCOME MEASURES Prevalence or risk of TB multimorbidity (primary); any measure of burden of disease (secondary). RESULTS From the 7557 search results, 54 were included, representing >6 296 000 people with TB. We found that the most prevalent conditions in people with TB were depression (45.19%, 95% CI: 38.04% to 52.55%, 25 studies, 4903 participants, I2=96.28%, high quality), HIV (31.81%, 95% CI: 27.83% to 36.07%, 68 studies, 62 696 participants, I2=98%, high quality) and diabetes mellitus (17.7%, 95% CI: 15.1% to 20.0.5%, 48 studies, 48,036 participants, I2=98.3%, critically low quality). CONCLUSIONS We identified several chronic conditions that co-occur in a significant proportion of people with TB. Although limited by varying quality and gaps in the literature, this first meta-review of TB multimorbidity highlights the magnitude of additional ill health burden due to chronic conditions on people with TB. PROSPERO REGISTRATION NUMBER CRD42020209012.
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Affiliation(s)
| | - Eugenia Romano
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Saima Afaq
- Institute of Public Health and Social Sciences, Khyber Medical University, Peshawar, Pakistan
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | | | - Yan Lin
- International Union Against Tuberculosis and Lung Disease, Beijing, China
| | - Rumana Huque
- Economics, University of Dhaka, Dhaka, Bangladesh
| | - Helen Elsey
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, Hull, UK
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, Hull, UK
| | - B Stubbs
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Najma Siddiqi
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, Hull, UK
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3
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Booth G, Howarth A, Stubbs B, Ussher M. The effectiveness of interventions targeting physical activity and sedentary behaviour in people with persistent musculoskeletal pain: Systematic review and meta-analysis. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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4
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Richter A, Stapel B, Heitland I, Westhoff-Bleck M, Ponimaskin E, Stubbs B, Lichtinghagen R, Hartung D, Kahl KG. Epicardial adipose tissue and adrenal gland volume in patients with borderline personality disorder. J Psychiatr Res 2021; 144:323-330. [PMID: 34715600 DOI: 10.1016/j.jpsychires.2021.10.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 11/25/2022]
Abstract
Borderline personality disorder (BPD) is associated with an elevated mortality risk that is partially attributed to suicide, but few studies examined other possible causes of premature death. The present study compared epicardial adipose tissue (EAT) volume as a known early predictor of premature cardiovascular morbidity, cardiovascular risk indices, and adrenal gland volume (AGV) as an indicator for chronic hypothalamus-pituitary-adrenal (HPA) axis activation in females with borderline personality disorder (BPD), major depressive disorder (MDD) and in healthy individuals. Twenty-eight patients with BPD comorbid with MDD (BPD/MDD), 22 MDD patients and 26 healthy females (CTRL) of comparable age were included. EAT and AGV were assessed by magnetic resonance tomography; 10-year cardiovascular risk and diabetes risk were determined by PROCAM and FINDRISK score; metabolic syndrome was defined following National Cholesterol Education Adult Treatment Panel III R (NCEP/ATP III) criteria. MADRS was used to assess depression severity. After adjustment for age, body mass index (BMI), and physical activity, EAT and AGV were significantly increased in BPD/MDD compared to MDD and CTRL. EAT and AGV displayed a positive correlation. Finally, diabetes risk in BPD/MDD was elevated compared to CTRL and MDD. The present study highlights the increased cardiometabolic risk of BPD patients. We identify EAT accumulation as an early predictor and potential mediator of cardiovascular disease in BPD that appears to be driven at least in part by HPA axis dysregulation. Therefore, interventions that reduce EAT volume (i.e. exercise and diet) should be considered in the clinical management of BPD.
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Affiliation(s)
- A Richter
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - B Stapel
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
| | - I Heitland
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - M Westhoff-Bleck
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - E Ponimaskin
- Institute of Cellular Neurophysiology, Hannover Medical School, Hannover, Germany
| | - B Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Maudsley NHS Foundation Trust, London, UK
| | - R Lichtinghagen
- Institute of Clinical Chemistry, Hannover Medical School, Hannover, Germany
| | - D Hartung
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - K G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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5
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Rahman NA, Stubbs B. Evolution of reporting P values in key physiotherapy journals over 10 and 20 years: An observational study. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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6
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Choi MJ, Yang JW, Lee S, Kim JY, Oh JW, Lee J, Stubbs B, Lee KH, Koyanagi A, Hong SH, Ghayda RA, Hwang J, Dragioti E, Jacob L, Carvalho AF, Radua J, Thompson T, Smith L, Fornaro M, Stickley A, Bettac EL, Han YJ, Kronbichler A, Yon DK, Lee SW, Shin JI, Lee E, Solmi M. Suicide associated with COVID-19 infection: an immunological point of view. Eur Rev Med Pharmacol Sci 2021; 25:6397-6407. [PMID: 34730221 DOI: 10.26355/eurrev_202110_27013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Coronavirus disease 2019 (COVID-19) is a pandemic and leading cause of death. Beyond the deaths directly caused by the virus and the suicides related to the psychological response to the dramatic changes as socioeconomic related to the pandemic, there might also be suicides related to the inflammatory responses of the infection. Infection induces inflammation as a cytokine storm, and there is an increasing number of studies that report a relationship between infection and suicide. MATERIALS AND METHODS We searched the World Health Organization status report and the PubMed database for keywords (COVID-19, suicide, infection, inflammation, cytokines), and reviewed five cytokine pathways between suicide and inflammation using two meta-analyses and two observational studies starting from November 31, 2020, focusing on the relationship between suicide and inflammation by infection. First, we discussed existing evidence explaining the relationship between suicidal behaviors and inflammation. Second, we summarized the inflammatory features found in COVID-19 patients. Finally, we highlight the potential for these factors to affect the risk of suicide in COVID-19 patients. RESULTS Patients infected with COVID-19 have high amounts of IL-1β, IFN-γ, IP10, and MCP1, which may lead to Th1 cell response activation. Also, Th2 cytokines (e.g., IL-4 and IL-10) were increased in COVID-19 infection. In COVID-19 patients, neurological conditions, like headache, dizziness, ataxia, seizures, and others have been observed. CONCLUSIONS COVID-19 pandemic can serve as a significant environmental factor contributing directly to increased suicide risk; the role of inflammation by an infection should not be overlooked.
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Affiliation(s)
- M J Choi
- Yonsei University College of Medicine, Seoul, Republic of Korea.
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7
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Stubbs B. Poor physical activity as a risk factor for mental health disorders. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Rates of common mental disorders appear to be increasing among both adolescent and adult population affecting life quality and expectancy. Availability of the treatments il limited to a large portion of the global population thus new approaches toward the prevention and treatment of mental illnesses need to emerge in order to reduce the global and growing burden of these conditions. A great body of evidence has linked both the onset and symptoms of various mental disorders to lifestyle factors such as physical activity and diet. Given their modifiable nature, there has been an increasing interest in the implementation of physical activity in the prevention and adjunctive treatment among people with mental illnesses. Robust evidence indicates that physical activity may in fact, by influencing a range of biological and psychosocial processes, contribute to healthy aging, improve sleep and preserve cognition across the lifespan as well as affect associated with mental disorders serious physical health comorbidities including cardiovascular disease, metabolic risk factors such as adiposity and premature mortality. The plausible effects of physical activity toward mental health may be at least partially explained by its potential in modulating hippocampal neurogenesis and synaptic plasticity. Finally, higher levels of physical activity have been consistently associated with a reduced risk of both affective and cognitive disorders.
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Affiliation(s)
- B Stubbs
- Department of Psychological Medicine, King's College London, London, UK
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8
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Jeong DY, Lee J, Kim JY, Lee KH, Li H, Lee JY, Jeong GH, Yoon S, Park EL, Hong SH, Kang JW, Song TJ, Leyhe T, Eisenhut M, Kronbichler A, Smith L, Solmi M, Stubbs B, Koyanagi A, Jacob L, Stickley A, Thompson T, Dragioti E, Oh H, Brunoni AR, Carvalho AF, Kim MS, Yon DK, Lee SW, Yang JM, Ghayda RA, Shin JI, Fusar-Poli P. Empirical assessment of biases in cerebrospinal fluid biomarkers of Alzheimer's disease: an umbrella review and re-analysis of data from meta-analyses. Eur Rev Med Pharmacol Sci 2021; 25:1536-1547. [PMID: 33629323 DOI: 10.26355/eurrev_202102_24862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Alzheimer's disease (AD) is a leading cause of years lived with disability in older age, and several cerebrospinal fluid (CSF) markers have been proposed in individual meta-analyses to be associated with AD but field-wide evaluation and scrutiny of the literature is not available. MATERIALS AND METHODS We performed an umbrella review for the reported associations between CSF biomarkers and AD. Data from available meta-analyses were reanalyzed using both random and fixed effects models. We also estimated between-study heterogeneity, small-study effects, excess significance, and prediction interval. RESULTS A total of 38 meta-analyses on CSF markers from 11 eligible articles were identified and reanalyzed. In 14 (36%) of the meta-analyses, the summary estimate and the results of the largest study showed non-concordant results in terms of statistical significance. Large heterogeneity (I2≥75%) was observed in 73% and small-study effects under Egger's test were shown in 28% of CSF biomarkers. CONCLUSIONS Our results suggest that there is an excess of statistically significant results and significant biases in the literature of CSF biomarkers for AD. Therefore, the results of CSF biomarkers should be interpreted with caution.
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Affiliation(s)
- D Y Jeong
- Yonsei University College of Medicine, Seoul, Republic of Korea.
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9
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Vancampfort D, Firth J, Smith L, Stubbs B, Rosenbaum S, Hallgren M, Van Damme T, Koyanagi A. Association between physical activity and leisure-time sedentary behavior among 140,808 adolescents aged 12 to 15 from 47 low- and middle-income countries. Public Health 2021; 199:1-9. [PMID: 34509709 DOI: 10.1016/j.puhe.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/11/2021] [Accepted: 08/01/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Data from high-income countries (HICs) indicate that sedentary behavior is negatively associated with moderate-to-vigorous physical activity (MVPA) in young people. We examined associations between leisure-time sedentary behavior (LTSB) and MVPA in adolescents from 47 low- and middle-income countries (LMICs). STUDY DESIGN Cross-sectional study. METHODS Data from the Global school-based Student Health Survey were analyzed in 140,808 adolescents (13.8 ± 1.0 years; 49% girls). Time spent in LTSB was a composite variable assessing time spent sitting and playing computer games, watching TV, talking with friends during a typical day. The PACE + Adolescent Physical Activity Measure assessed MVPA levels. The association between ≥3 h/day of LTSB and adequate physical activity levels (every day last week 60 min MVPA) was explored with multivariable logistic regression analyses. RESULTS The prevalence of ≥3 h/day of LTSB and 60 min of MVPA/day last week were 26.3% (girls 26.2%; boys 26.5%) and 15.3% (girls 12.1%; boys 18.4%), respectively. LTSB of ≥3 h/day versus <3 h/day was associated with a 35% increased odds for adequate levels of MVPA in boys [OR = 1.35 (95%CI = 1.23-1.48)] and 22% in girls [1.22 (95%CI = 1.10-1.36)]. CONCLUSIONS Our data indicate that being physically active 60 min per day every day and at moderate-to-vigorous intensity and being sedentary ≥3 h/day during leisure-time might co-exist in adolescents in some LMICs.
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Affiliation(s)
- D Vancampfort
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Kortenberg, Belgium.
| | - J Firth
- NICM Health Research Institute, School of Science and Health, University of Western Sydney, Australia; Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - L Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom
| | - S Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Prince of Wales Hospital, Sydney, Australia
| | - M Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - T Van Damme
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, CIBERSAM, Barcelona, Spain; ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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10
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Kandola AA, Del Pozo Cruz B, Osborn DPJ, Stubbs B, Choi KW, Hayes JF. Impact of replacing sedentary behaviour with other movement behaviours on depression and anxiety symptoms: a prospective cohort study in the UK Biobank. BMC Med 2021; 19:133. [PMID: 34134689 PMCID: PMC8210357 DOI: 10.1186/s12916-021-02007-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 05/17/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Sedentary behaviour is potentially a modifiable risk factor for depression and anxiety disorders, but findings have been inconsistent. To assess the associations of sedentary behaviour with depression and anxiety symptoms and estimate the impact of replacing daily time spent in sedentary behaviours with sleep, light, or moderate to vigorous physical activity, using compositional data analysis methods. METHODS We conducted a prospective cohort study in 60,235 UK Biobank participants (mean age: 56; 56% female). Exposure was baseline daily movement behaviours (accelerometer-assessed sedentary behaviour and physical activity, and self-reported total sleep). Outcomes were depression and anxiety symptoms (Patient Health Questionnaire-9 and Generalised Anxiety Disorders-7) at follow-up. RESULTS Replacing 60 min of sedentary behaviour with light activity, moderate-to-vigorous activity, and sleep was associated with lower depression symptom scores by 1.3% (95% CI, 0.4-2.1%), 12.5% (95% CI, 11.4-13.5%), and 7.6% (95% CI, 6.9-8.4%), and lower odds of possible depression by 0.95 (95% CI, 0.94-0.96), 0.75 (95% CI, 0.74-0.76), and 0.90 (95% CI, 0.90-0.91) at follow-up. Replacing 60 min of sedentary behaviour with moderate-to-vigorous activity and sleep was associated with lower anxiety symptom scores by 6.6% (95% CI, 5.5-7.6%) and 4.5% (95% CI, 3.7-5.2%), and lower odds of meeting the threshold for a possible anxiety disorder by 0.90 (95% CI, 0.89-0.90) and 0.97 (95%CI, 0.96-0.97) at follow-up. However, replacing 60 min of sedentary behaviour with light activity was associated with higher anxiety symptom scores by 4.5% (95% CI, 3.7-5.3%) and higher odds of a possible anxiety disorder by 1.07 (95% CI, 1.06-1.08). CONCLUSIONS Sedentary behaviour is a risk factor for increased depression and anxiety symptoms in adults. Replacing sedentary behaviour with moderate-to-vigorous activity may reduce mental health risks, but more work is necessary to clarify the role of light activity.
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Affiliation(s)
- A A Kandola
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Rd, London, W1T 7BN, UK. .,Institute of Mental Health, University College London, London, UK.
| | - B Del Pozo Cruz
- Motivation and Behaviour Program, Institute for Positive Psychology and Education, Faculty of Health Sciences, Australian Catholic University, Sydney, Australia
| | - D P J Osborn
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Rd, London, W1T 7BN, UK.,Camden and Islington NHS Foundation Trust, London, UK
| | - B Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.,Physiotherapy Department, South London, and Maudsley National Health Services Foundation Trust, London, UK
| | - K W Choi
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Psychiatric & Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.,Stanley Center for Psychiatric Research, Broad Institute, Boston, MA, USA
| | - J F Hayes
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Rd, London, W1T 7BN, UK.,Camden and Islington NHS Foundation Trust, London, UK
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11
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Kandola A, Del Pozo Cruz B, Osborn D, Stubbs B, Choi K, Hayes J. 24-hour movement behaviours and the risk of common mental health symptoms: A compositional analysis in the UK biobank. Eur Psychiatry 2021. [PMCID: PMC9470470 DOI: 10.1192/j.eurpsy.2021.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Sedentary behaviour is potentially a modifiable risk factor for depression and anxiety disorders, but findings have been inconsistent. Objectives To assess associations of sedentary behavior with depression and anxiety symptoms and estimate the impact of replacing daily time spent in sedentary behaviors with sleep, light, or moderate-to-vigorous physical activity, using novel compositional data analysis methods. Methods Prospective cohort study in with 60,235 UK Biobank participants (mean age: 56; 56% female). Exposure was baseline daily movement behaviours (accelerometer-assessed sedentary behaviour, physical activity, and self-reported total sleep). Outcomes were depression and anxiety symptoms (Patient Health Questionnaire-9 and Generalised Anxiety Disorders-7) at follow up. Results Replacing 60 minutes of sedentary behaviour with light activity, moderate-to-vigorous activity, and sleep was associated with lower depression symptom scores by 1·3% (95%CI, 0·4%-2·1%), 12·5% (95%CI, 11·4%-13·5%), and 7·6% (95%CI, 6·9%-8·4%), and lower odds of depression by 0·95 (95%CI, 0·94-0·96), 0·75 (95%CI, 0·74-0·76), and 0·90 (95%CI, 0·90-0·91) at follow-up. Replacing 60 minutes of sedentary behaviour with moderate-to-vigorous activity and sleep was associated with lower anxiety symptom scores by 6·6% (95%CI, 5·5%-7·6%) and 4·5% (95%CI, 3·7%-5·2%), and lower odds of meeting the threshold for an anxiety disorder by 0·90 (95%CI, 0·89-0·90) and 0·97 (95%CI, 0·96-0·97) at follow-up. However, replacing 60 minutes of sedentary behaviour with light activity was associated with higher anxiety symptom scores by 4·5% (95%CI, 3·7%-5·3%) and higher odds of an anxiety disorder by 1·07 (95%CI, 1·06-1·08). Conclusions Sedentary behaviour is a risk factor for increased depression and anxiety symptoms in adults, but different replacement activities differentially influence mental health. Disclosure No significant relationships.
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Siddiqi K, Stubbs B, Lin Y, Elsey H, Siddiqi N. TB multimorbidity: a global health challenge demanding urgent attention. Int J Tuberc Lung Dis 2021; 25:87-90. [PMID: 33656417 DOI: 10.5588/ijtld.20.0751] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- K Siddiqi
- Department of Health Sciences, The University of York and Hull York Medical School, University of York, York, UK
| | - B Stubbs
- Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK
| | - Y Lin
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - H Elsey
- Department of Health Sciences, The University of York and Hull York Medical School, University of York, York, UK
| | - N Siddiqi
- Department of Health Sciences, The University of York and Hull York Medical School, University of York, York, UK
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13
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Vilches-Moraga A, Price A, Braude P, Pearce L, Short R, Verduri A, Stechman M, Collins JT, Mitchell E, Einarsson AG, Moug SJ, Quinn TJ, Stubbs B, McCarthy K, Myint PK, Hewitt J, Carter B. Increased care at discharge from COVID-19: The association between pre-admission frailty and increased care needs after hospital discharge; a multicentre European observational cohort study. BMC Med 2020; 18:408. [PMID: 33334341 PMCID: PMC7746415 DOI: 10.1186/s12916-020-01856-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 11/17/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has placed significant pressure on health and social care. Survivors of COVID-19 may be left with substantial functional deficits requiring ongoing care. We aimed to determine whether pre-admission frailty was associated with increased care needs at discharge for patients admitted to hospital with COVID-19. METHODS Patients were included if aged over 18 years old and admitted to hospital with COVID-19 between 27 February and 10 June 2020. The Clinical Frailty Scale (CFS) was used to assess pre-admission frailty status. Admission and discharge care levels were recorded. Data were analysed using a mixed-effects logistic regression adjusted for age, sex, smoking status, comorbidities, and admission CRP as a marker of severity of disease. RESULTS Thirteen hospitals included patients: 1671 patients were screened, and 840 were excluded including, 521 patients who died before discharge (31.1%). Of the 831 patients who were discharged, the median age was 71 years (IQR, 58-81 years) and 369 (44.4%) were women. The median length of hospital stay was 12 days (IQR 6-24). Using the CFS, 438 (47.0%) were living with frailty (≥ CFS 5), and 193 (23.2%) required an increase in the level of care provided. Multivariable analysis showed that frailty was associated with an increase in care needs compared to patients without frailty (CFS 1-3). The adjusted odds ratios (aOR) were as follows: CFS 4, 1.99 (0.97-4.11); CFS 5, 3.77 (1.94-7.32); CFS 6, 4.04 (2.09-7.82); CFS 7, 2.16 (1.12-4.20); and CFS 8, 3.19 (1.06-9.56). CONCLUSIONS Around a quarter of patients admitted with COVID-19 had increased care needs at discharge. Pre-admission frailty was strongly associated with the need for an increased level of care at discharge. Our results have implications for service planning and public health policy as well as a person's functional outcome, suggesting that frailty screening should be utilised for predictive modelling and early individualised discharge planning.
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Affiliation(s)
- A Vilches-Moraga
- Faculty of Medical and Human Services, University of Manchester, Manchester, England
- Salford Royal Hospital Foundation Trust, Salford, England
| | - A Price
- Salford Royal Hospital Foundation Trust, Salford, England
| | - P Braude
- North Bristol NHS Trust, Bristol, England
| | - L Pearce
- Faculty of Medical and Human Services, University of Manchester, Manchester, England
- Salford Royal Hospital Foundation Trust, Salford, England
| | - R Short
- Department of Biostatistics and Health Informatics, King's College London, London, England
| | - A Verduri
- University Hospital of Modena Policlinico, University of Modena and Reggio Emilia, Modena, Italy
| | - M Stechman
- University Hospital of Wales, Cardiff University, Cardiff, Wales
| | - J T Collins
- Ysbyty Ystrad Fawr, Aneurin Bevan University Health Board, Newport, Wales
| | - E Mitchell
- North Bristol NHS Trust, Bristol, England
| | | | - S J Moug
- Royal Alexandra Hospital, Paisley, Scotland
| | - T J Quinn
- Glasgow Royal Infirmary, Glasgow, Scotland
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK
| | - K McCarthy
- North Bristol NHS Trust, Bristol, England
| | - P K Myint
- University of Aberdeen, Aberdeen, Scotland
| | - J Hewitt
- Aneurin Bevan Health Board, Cardiff University, Cardiff, Wales
| | - B Carter
- Department of Biostatistics and Health Informatics, King's College London, London, England.
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Vancampfort D, Schuch F, Van Damme T, Firth J, Suetani S, Stubbs B, Van Biesen D. Metabolic syndrome and its components in people with intellectual disability: a meta-analysis. J Intellect Disabil Res 2020; 64:804-815. [PMID: 32893439 DOI: 10.1111/jir.12772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND People with intellectual disability have an increased risk for cardiovascular diseases and associated premature mortality. Metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. The aim of this meta-analysis was to describe the pooled prevalence of MetS and its components in people with intellectual disability taking into account variations in demographic, clinical and treatment-related variables. METHODS Pubmed, Embase and CINAHL were searched until 5 August 2020 for studies reporting cross-sectional data on prevalences of MetS and its components in people with intellectual disability. Two independent reviewers extracted data. Random effects meta-analyses with subgroup and meta-regression analyses were employed. RESULTS The pooled MetS prevalence after adjusting for publication bias was 22.5% [95% confidence interval (CI) = 16.8%-29.6%; N studies = 10; n participants = 2443, median age at study level = 38.5 years; 52% male]. Abdominal obesity was observed in 52.0% (95% CI = 42.0%-61.9%; I2 = 86.5; N = 5; n = 844), hypertension in 36.7% (95% CI = 26.1%-48.7%; N = 6; n = 926), hypertriglyceridaemia in 23.5% (95% CI = 18.8%-28.9%; N = 5; n = 845), low high-density-lipoprotein-cholesterol in 23.4% (95% CI = 19.3%-28.0%; N = 6; n = 917), and hyperglycaemia in 10.2% (95% CI = 7.6%-13.3%; N = 5; n = 845). Meta-regression revealed that a higher MetS frequency was moderated by older age (coefficient = 0.03; standard error = 0.01, 95% CI = 0.008 to 0.055; N = 19; n = 2443) and a higher proportion of people on antidepressants in the study (coefficient = 7.24; standard error = 0.90, 95% CI = 5.48-9.00; N = 4; n = 546). There were insufficient data comparing MetS in people with intellectual disability with age-matched and gender-matched controls. CONCLUSIONS Considering that more than one fifth of people with intellectual disability have MetS, routine screening and multidisciplinary management of metabolic abnormalities in people with intellectual disability is needed. Attention should be given to older people and those on antidepressants.
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Affiliation(s)
- D Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- University Psychiatric Center, KU Leuven, Leuven, Belgium
| | - F Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - T Van Damme
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- University Psychiatric Center, KU Leuven, Leuven, Belgium
| | - J Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- NICM Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
| | - S Suetani
- Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
- Queensland Brain Institute, The University of Queensland, St Lucia, Queensland, Australia
- School of Medicine, Griffith University, Nathan, Queensland, Australia
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - D Van Biesen
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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15
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Olanrewaju O, Stockwell S, Stubbs B, Smith L. Sedentary behaviours, cognitive function, and possible mechanisms in older adults: a systematic review. Aging Clin Exp Res 2020; 32:969-984. [PMID: 32026419 DOI: 10.1007/s40520-019-01457-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 12/18/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Physical activity can improve cognitive function of older adults, but the influence of sedentary behaviour on cognition is less clear. This systematic review investigated associations between sedentary behaviour and cognitive function in older adults without dementia, and possible mechanisms involved. METHODS Major databases were searched for studies in English between 01/01/1999 and 31/10/2019. The systematic review followed COSMOS-E guideline and a pre-registered protocol (CRD42019122229). Risk of bias was assessed using NICE Quality appraisal checklist. Findings were narratively synthesized and presented. FINDINGS Eighteen studies comprised of 13 cross-sectional and five longitudinal analyses (n = 40,228). Evidence suggested varied associations between varied sedentary behaviours and cognitive function in older adults. 50% of study analyses did not control for physical activity. 3/18 studies demonstrated associations between higher sedentary levels and lower levels of brain biomarkers, while 1/18 showed auto-regulatory effect in the left hippocampus. Conducting a meta-analysis was not justifiable due to considerable methodological, participant, outcome and exposure heterogeneity. CONCLUSION There is a lack of clarity about the overall and independent association between sedentary behaviour and cognition in older age. Underlying mechanisms are similar to physical activity and probably multi-modal. More studies with robust designs and methodology are needed to confirm effect of sedentary behaviour on cognition.
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Affiliation(s)
| | | | - B Stubbs
- Positive Ageing Research Institute, FHSCME, Anglia Ruskin University, South London and Maudsley Foundation NHS Trust, London, UK
| | - L Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
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16
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Guerra J, Smith L, Vicinanza D, Stubbs B, Veronese N, Williams G. The use of sonification for physiotherapy in human movement tasks: A scoping review. Sci Sports 2020. [DOI: 10.1016/j.scispo.2019.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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Salagre E, Vizuete A, Leite M, Brownstein D, McGuinness A, Jacka F, Dodd S, Stubbs B, Köhler C, Vieta E, Carvalho A, Berk M, Fernandes B. Homocysteine as a peripheral biomarker in bipolar disorder: A meta-analysis. Eur Psychiatry 2020; 43:81-91. [DOI: 10.1016/j.eurpsy.2017.02.482] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/13/2017] [Accepted: 02/14/2017] [Indexed: 12/13/2022] Open
Abstract
AbstractBackground:Bipolar disorder (BD) is a psychiatric disorder with an uncertain aetiology. Recently, special attention has been given to homocysteine (Hcy), as it has been suggested that alterations in 1-carbon metabolism might be implicated in diverse psychiatric disorders. However, there is uncertainty regarding possible alterations in peripheral Hcy levels in BD.Methods:This study comprises a meta-analysis comparing serum and plasma Hcy levels in persons with BD and healthy controls. We conducted a systematic search for all eligible English and non-English peer-reviewed articles.Results:Nine cross-sectional studies were included in the meta-analyses, providing data on 1547 participants. Random-effects meta-analysis showed that serum and plasma levels of Hcy were increased in subjects with BD in either mania or euthymia when compared to healthy controls, with a large effect size in the mania group (g= 0.98, 95% CI: 0.8–1.17,P< 0.001,n= 495) and a small effect in the euthymia group (g= 0.3, 95% CI: 0.11–0.48,P= 0.002,n= 1052).Conclusions:Our meta-analysis provides evidence that Hcy levels are elevated in persons with BD during mania and euthymia. Peripheral Hcy could be considered as a potential biomarker in BD, both of trait (since it is increased in euthymia), and also of state (since its increase is more accentuated in mania). Longitudinal studies are needed to clarify the relationship between bipolar disorder and Hcy, as well as the usefulness of peripheral Hcy as both a trait and state biomarker in BD.
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18
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Lally J, Ajnakina O, Stubbs B, Cullinane M, Murphy K, Gaughran F, Murray R. Remission and recovery from first-episode psychosis in adults: A systematic review and meta-analysis of long-term outcome studies. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2017.01.1595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
IntroductionRemission and recovery rates for people who have had a first episode psychosis (FEP) remain uncertain.ObjectivesWe conducted a systematic review and meta-analysis to assess pooled prevalence rates of remission and recovery in FEP in longitudinal studies and conducted meta regression analyses to investigate potential moderators.MethodsA systematic literature search of major electronic databases without language restrictions was conducted from database inception until July 1, 2016. Longitudinal studies with follow up greater than 1 year reporting data on remission or recovery rates in FEP were included.ResultsSeventy-nine studies were included representing 19,072 FEP patients (mean age = 26.9 years, male = 59.5%). The pooled rate of remission among 12,301 individuals with FEP was 57.9% (95%CI: 52.7–62.9, Q = 1536.3, P< 0.001, n = 60 studies, mean follow up = 5.5 years). Restricting the analysis to studies, which used the remission in schizophrenia working group (RSWG) criteria (n = 25 studies, n = 6909 patients), the pooled remission rate was 56.9% (95%CI: 48.9–64.5, Q = 656.9). Higher remission rates were moderated by studies from more recent years. The pooled prevalence of recovery among 9642 individuals with FEP was 37.9% (95%CI: 30.0–46.5, Q = 1450.8, studies = 35, P = 0.006, average follow up = 7.2 years). Recovery rates were higher (P< 0.05) in North America compared to other regions.ConclusionsOur data suggest that remission and recovery rates in FEP may be more favorable than previously thought. We observed stability of recovery rates after the first two years, suggesting that a progressive deteriorating course of illness is not typical. While remission rates have improved over time, recovery rates have not, raising questions about the effectiveness of specialist early intervention services in achieving improved recovery.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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19
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Rosenbaum S, Morell R, Abdel-Baki A, Ahmadpanah M, Anilkumar TV, Baie L, Bauman A, Bender S, Boyan Han J, Brand S, Bratland-Sanda S, Bueno-Antequera J, Camaz Deslandes A, Carneiro L, Carraro A, Castañeda CP, Castro Monteiro F, Chapman J, Chau JY, Chen LJ, Chvatalova B, Chwastiak L, Corretti G, Dillon M, Douglas C, Egger ST, Gaughran F, Gerber M, Gobbi E, Gould K, Hatzinger M, Holsboer-Trachsler E, Hoodbhoy Z, Imboden C, Indu PS, Iqbal R, Jesus-Moraleida FR, Kondo S, Ku PW, Lederman O, Lee EHM, Malchow B, Matthews E, Mazur P, Meneghelli A, Mian A, Morseth B, Munguia-Izquierdo D, Nyboe L, O’Donoghue B, Perram A, Richards J, Romain AJ, Romaniuk M, Sadeghi Bahmani D, Sarno M, Schuch F, Schweinfurth N, Stubbs B, Uwakwe R, Van Damme T, Van Der Stouwe E, Vancampfort D, Vetter S, Waterreus A, Ward PB. Assessing physical activity in people with mental illness: 23-country reliability and validity of the simple physical activity questionnaire (SIMPAQ). BMC Psychiatry 2020; 20:108. [PMID: 32143714 PMCID: PMC7060599 DOI: 10.1186/s12888-020-2473-0] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 01/30/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness. METHODS The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Patients with a DSM or ICD mental illness diagnoses were recruited and completed the SIMPAQ on two occasions, one week apart. Participants wore an Actigraph accelerometer and completed brief cognitive and clinical assessments. RESULTS Evidence of SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Data were obtained from 1010 participants. The SIMPAQ had good test-retest reliability. Correlations for moderate-vigorous physical activity was comparable to studies conducted in general population samples. Evidence of validity for the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had stronger evidence of validity. This alternative method is recommended for use in future studies employing the SIMPAQ. CONCLUSIONS The SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals.
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Affiliation(s)
- S. Rosenbaum
- grid.1005.40000 0004 4902 0432School of Psychiatry, UNSW Sydney, Sydney, Australia
| | - R. Morell
- grid.1005.40000 0004 4902 0432School of Psychiatry, UNSW Sydney, Sydney, Australia
| | - A. Abdel-Baki
- grid.410559.c0000 0001 0743 2111Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Canada
| | - M. Ahmadpanah
- grid.411950.80000 0004 0611 9280Behavioral Disorders and Substances Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - T. V. Anilkumar
- grid.413226.00000 0004 1799 9930Department of Psychiatry, Government Medical College, Trivandrum, India
| | - L. Baie
- grid.16149.3b0000 0004 0551 4246Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
| | - A. Bauman
- grid.1013.30000 0004 1936 834XSchool of Public Health, University of Sydney, Sydney, Australia
| | - S. Bender
- LWL-Klinik Marsberg, Hospital for Psychiatry, Psychotherapy and Psychosomatics, Marsberg, Germany
| | - J. Boyan Han
- grid.253561.60000 0001 0806 2909California State University, Los Angeles, USA
| | - S. Brand
- grid.6612.30000 0004 1937 0642University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland ,grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino, Urbino, Italy ,grid.477714.60000 0004 0587 919XThe Sutherland Hospital, South Eastern Sydney Local Health District, Sydney, Australia
| | - S. Bratland-Sanda
- Department of Sport, Physical Education and Outdoor Studies, University of South-Eastern Norway, Bø, Notodden, Norway
| | - J. Bueno-Antequera
- grid.15449.3d0000 0001 2200 2355Physical Performance & Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain
| | - A. Camaz Deslandes
- grid.8536.80000 0001 2294 473XPsychiatry Institute, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - L. Carneiro
- Research Centre in Sports Sciences, Health Sciences and Human Development, CIDESD, GERON Research Community, Vila Real, Portugal
| | - A. Carraro
- grid.34988.3e0000 0001 1482 2038Faculty of Education, Free University of Bolzano, Bolzano, Italy
| | - C. P. Castañeda
- Early Intervention Program, JHorwitz Psychiatric Institute, Santiago, Chile
| | - F. Castro Monteiro
- grid.8532.c0000 0001 2200 7498Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - J. Chapman
- grid.1049.c0000 0001 2294 1395QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - J. Y. Chau
- grid.1013.30000 0004 1936 834XSchool of Public Health, University of Sydney, Sydney, Australia ,grid.1004.50000 0001 2158 5405Department of Health Systems and Populations, Macquarie University, Sydney, Australia
| | - L. J. Chen
- grid.445057.7Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan
| | - B. Chvatalova
- grid.447902.cNational Institute of Mental Health, Klecany, Czech Republic
| | - L. Chwastiak
- grid.34477.330000000122986657Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
| | - G. Corretti
- Department of Mental Health, North-West Tuscany, Italy
| | - M. Dillon
- HSE Louth Meath Mental Health Services, Louth, Ireland
| | - C. Douglas
- South Coast Private Hospital, Wollongong, Australia
| | - S. T. Egger
- grid.10863.3c0000 0001 2164 6351Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain ,grid.7400.30000 0004 1937 0650Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - F. Gaughran
- grid.451052.70000 0004 0581 2008South London and Maudesley NHS Foundation Trust, London, UK
| | - M. Gerber
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino, Urbino, Italy
| | - E. Gobbi
- grid.6612.30000 0004 1937 0642Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, University of Basel, Basel, Switzerland
| | - K. Gould
- grid.460013.0St John of God Hospital, North Richmond, Australia
| | - M. Hatzinger
- Psychiatric Services Solothurn, Solothurn, Switzerland
| | - E. Holsboer-Trachsler
- grid.6612.30000 0004 1937 0642Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
| | - Z. Hoodbhoy
- grid.7147.50000 0001 0633 6224Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - C. Imboden
- Psychiatric Services Solothurn, Solothurn, Switzerland ,Private Clinic Wyss, Muenchenbuchsee, Switzerland
| | - P. S. Indu
- grid.413226.00000 0004 1799 9930Department of Community Medicine, Government Medical College, Trivandrum, India
| | - R. Iqbal
- grid.7147.50000 0001 0633 6224Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - F. R. Jesus-Moraleida
- grid.8395.70000 0001 2160 0329Department of Physical Therapy, Universidade Federal do Ceará, Fortaleza, Brazil
| | - S. Kondo
- grid.412708.80000 0004 1764 7572Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan
| | - P. W. Ku
- grid.412038.c0000 0000 9193 1222Graduate Institute of Sports and Health, National Changhua University of Education, Changhua, Taiwan
| | - O. Lederman
- grid.477714.60000 0004 0587 919XKeeping the Body In Mind, South Eastern Sydney Local Health District, Sydney, Australia
| | - E. H. M. Lee
- grid.194645.b0000000121742757Department of Psychiatry, University of Hong Kong, Hong Kong, China
| | - B. Malchow
- grid.411984.10000 0001 0482 5331Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - E. Matthews
- grid.24349.380000000106807997School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - P. Mazur
- LWL-Klinik Marsberg, Hospital for Psychiatry, Psychotherapy and Psychosomatics, Marsberg, Germany
| | - A. Meneghelli
- Association of early intervention in mental disorders-Cambiare la Rotta-Onlus, Milano, Italy
| | - A. Mian
- grid.7147.50000 0001 0633 6224Department of Psychiatry, Aga Khan University, Karachi, Pakistan
| | - B. Morseth
- grid.10919.300000000122595234School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - D. Munguia-Izquierdo
- grid.15449.3d0000 0001 2200 2355Physical Performance & Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain
| | - L. Nyboe
- grid.154185.c0000 0004 0512 597XDepartment of Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
| | - B. O’Donoghue
- grid.488501.0Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia
| | - A. Perram
- grid.267827.e0000 0001 2292 3111Faculty of Health, Victoria University Wellington, Wellington, New Zealand
| | - J. Richards
- grid.1013.30000 0004 1936 834XSchool of Public Health, University of Sydney, Sydney, Australia ,Gallipoli Medical Research Institute, Brisbane, Australia
| | - A. J. Romain
- grid.410559.c0000 0001 0743 2111Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Canada
| | - M. Romaniuk
- grid.412112.50000 0001 2012 5829Kermanshah University of Medical Sciences, Sleep Disorders and Substance Abuse Prevention Research Center, Kermanshah, Iran
| | - D. Sadeghi Bahmani
- grid.6612.30000 0004 1937 0642University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland ,grid.477714.60000 0004 0587 919XThe Sutherland Hospital, South Eastern Sydney Local Health District, Sydney, Australia
| | - M. Sarno
- Association of early intervention in mental disorders-Cambiare la Rotta-Onlus, Milano, Italy
| | - F. Schuch
- grid.411239.c0000 0001 2284 6531Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - N. Schweinfurth
- grid.6612.30000 0004 1937 0642University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland
| | - B. Stubbs
- grid.13097.3c0000 0001 2322 6764Department of Psychological Medicine, King’s College London, London, England
| | - R. Uwakwe
- grid.412207.20000 0001 0117 5863Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
| | - T. Van Damme
- grid.5596.f0000 0001 0668 7884Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - E. Van Der Stouwe
- grid.4494.d0000 0000 9558 4598University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Groningen, Netherlands
| | - D. Vancampfort
- grid.5596.f0000 0001 0668 7884Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - S. Vetter
- grid.7400.30000 0004 1937 0650Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - A. Waterreus
- grid.1012.20000 0004 1936 7910Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, University of Western Australia, Perth, Australia
| | - P. B. Ward
- grid.1005.40000 0004 4902 0432School of Psychiatry, UNSW Sydney, Sydney, Australia ,grid.429098.eSchizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, Australia
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Kandola A, Stubbs B, Koyanagi A. Physical multimorbidity and sedentary behavior in older adults: Findings from the Irish longitudinal study on ageing (TILDA). Maturitas 2020; 134:1-7. [PMID: 32143770 DOI: 10.1016/j.maturitas.2020.01.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/07/2020] [Accepted: 01/12/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND Physical multimorbidity, defined as the presence of two or more chronic physical conditions, is widespread and reduces life expectancy and quality of life in older adults. Sedentary behavior (SB) is increasingly identified as a risk factor for a range of chronic physical conditions, independent of physical activity. OBJECTIVES To investigate associations between physical multimorbidity and SB in older adults. STUDY DESIGN We used cross-sectional data from a population-based sample of 6903 adults aged ≥50 years who participated in the Irish Longitudinal Study on Ageing (TILDA) in 2009-2011. We conducted multivariable linear and logistic regression analyses to assess associations between multimorbidity and SB. MAIN OUTCOME MEASURES Self-reported minutes/day of SB and high SB (≥ 8 h/day). RESULTS We found that most of the 14 individual chronic physical conditions included here were associated with greater SB. Those with stroke (OR = 2.63, 95 % CI = 1.69, 4.10) and cirrhosis (OR = 2.53, 95 %CI = 1.19, 5.41) were the most likely to be classified with high SB. Time spent in SB and the prevalence of high SB increased linearly with number of chronic conditions. Multivariable regression models adjusting for sociodemographic and psychological factors, disability, social network, and physical activity showed that, compared with people with none, those with ≥4 chronic physical conditions had 1.45 times greater odds (OR = 1.45, 95 % CI = 1.09, 1.93) of high SB and higher mean minutes/day of SB (β = 21.37, 95 % CI = 5.53, 37.20). CONCLUSIONS Our results suggest that physical multimorbidity is associated with SB and highlight the need for prospective research to examine the directionality and mechanisms of these associations.
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Affiliation(s)
- A Kandola
- Division of Psychiatry, University College London, London, UK.
| | - B Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; Physiotherapy Department, South London and Maudsley National Health Services Foundation Trust, London, UK
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain; ICREA, Barcelona, Spain
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21
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Martland R, Stubbs B. High-intensity interval training: an adjunctive treatment for schizophrenia spectrum disorders? Acta Psychiatr Scand 2019; 140:495-497. [PMID: 31755093 DOI: 10.1111/acps.13123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2019] [Indexed: 11/29/2022]
Affiliation(s)
- R Martland
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - B Stubbs
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
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22
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Kugathasan P, Stubbs B, Aagaard J, Jensen SE, Munk Laursen T, Nielsen RE. Increased mortality from somatic multimorbidity in patients with schizophrenia: a Danish nationwide cohort study. Acta Psychiatr Scand 2019; 140:340-348. [PMID: 31355419 DOI: 10.1111/acps.13076] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To investigate the association of single- and multimorbidity with mortality rates in patients with schizophrenia compared to the general population. METHOD A nationwide cohort study including residents in Denmark between 1995 and 2015. The cohort was dichotomously divided by a diagnosis of schizophrenia. Somatic diseases included infections, cancer, endocrine, neurologic, cardiovascular, respiratory, digestive, skin, musculoskeletal, and urogenital diseases. Hazard ratios (HRs) and population attributable fractions (PAFs) were calculated. RESULTS The cohort included 30 210 patients with schizophrenia [mean age (SD) = 32.6 (11.4), males = 57.2%], and 5 402 611 from the general population [mean age (SD) = 33.0 (14.5), males = 50.4%]. All number of somatic diseases were associated with an increased mortality in schizophrenia [HR = 16.3 (95% CI = 15.4-17.3) for 1 disease to 21.0 (95% CI = 19.1-23.0) for ≥5 diseases], using the general population with no somatic disease as reference. Across all somatic diseases, patients with schizophrenia showed a HR > 2, compared to the general population, and respiratory (PAF = 9.3%), digestive (PAF = 8.2%), and cardiovascular (PAF = 7.9%) diseases showed largest contributions to death. CONCLUSIONS Patients with schizophrenia showed higher mortality on all levels of multimorbidity, and a doubled mortality rate across all somatic diseases, compared to the general population. The findings suggest that the clusters and trajectories of symptoms associated with schizophrenia is the main driver of the excess mortality.
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Affiliation(s)
- P Kugathasan
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - B Stubbs
- South London and Maudsley NHS Foundation Trust, London, UK.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J Aagaard
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - S E Jensen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - T Munk Laursen
- National Centre for Register-Based Research, University of Aarhus, Aarhus, Denmark
| | - R E Nielsen
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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23
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Kandola A, Ashdown-Franks G, Stubbs B, Osborn DPJ, Hayes JF. The association between cardiorespiratory fitness and the incidence of common mental health disorders: A systematic review and meta-analysis. J Affect Disord 2019; 257:748-757. [PMID: 31398589 PMCID: PMC6997883 DOI: 10.1016/j.jad.2019.07.088] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/26/2019] [Accepted: 07/29/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Physical activity is associated with a lower incidence of common mental health disorder, but less is known about the impact of cardiorespiratory fitness (CRF). METHODS In this review, we systematically evaluated the relationship between CRF and the incidence of common mental health disorders in prospective cohort studies. We systematically searched six major electronic databases from inception to 23rd of May 2019. We assessed study quality using the Newcastle-Ottawa scale. RESULTS We were able to pool the hazard ratios (HRs) and 95% confidence intervals (CIs) of four studies including at least 27,733,154 person-years of data. We found that low CRF (HR = 1.47, [95% CI 1.23 - 1.76] p < 0.001 I2 = 85.1) and medium CRF (HR = 1.23, [95% CI 1.09 - 1.38] p < 0.001 I2 = 87.20) CRF are associated with a 47% and 23% greater risk of a common mental health disorders respectively, compared with high CRF. We found evidence to suggest a dose-response relationship between CRF and the risk of common mental health disorders. LIMITATIONS We were only able to identify a small number of eligible studies from our search and heterogeneity was substantial in the subsequent meta-analysis. CONCLUSIONS Our findings indicate that there is a longitudinal association between CRF levels and the risk of a common mental health disorder. CRF levels could be useful for identifying and preventing common mental health disorders at a population-level.
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Affiliation(s)
- A Kandola
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7BN, UK.
| | - G Ashdown-Franks
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AB, UK; Department of Exercise Sciences, University of Toronto, 27 King's College Circle, Toronto, Ontario, ON M5S, Canada
| | - B Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AB, UK; Physiotherapy Department, South London and Maudsley National Health Services Foundation Trust, London, SE5 8AZ, UK
| | - D P J Osborn
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7BN, UK
| | - J F Hayes
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7BN, UK
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24
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Zeng BS, Lin SY, Tu YK, Wu YC, Stubbs B, Liang CS, Yeh TC, Chen TY, Carvalho AF, Lin PY, Lei WT, Hsu CW, Chen YW, Tseng PT, Chen CH. Prevention of Postdental Procedure Bacteremia: A Network Meta-analysis. J Dent Res 2019; 98:1204-1210. [PMID: 31469596 DOI: 10.1177/0022034519870466] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Postdental procedure bacteremia is common and troublesome. The comparative efficacy of multiple prophylactic interventions is unclear. We compared the efficacy of interventions for the prevention of postdental procedure bacteremia. We conducted a review of ClinicalKey, Cochrane CENTRAL, Embase, ProQuest, PubMed, ScienceDirect, Web of Science, and ClinicalTrials.gov from inception to December 4, 2018. Randomized controlled trials that evaluated prophylactic interventions for the prevention of postdental procedure bacteremia were eligible. The primary outcome was the incidence of postdental procedure bacteremia. A total of 24 trials were included with 2,147 participants. Our network meta-analysis demonstrated that intravenous administration of 1,000/200 mg of amoxicillin/clavulanate provided the least incidence of postdental procedure bacteremia among all the prophylactic interventions (odds ratio = 0.03, 95% CI = 0.00 to 0.63) as compared with the placebo/controls. Oral 3 g of amoxicillin had the least incidence of postdental procedure bacteremia among all oral or topical forms of prophylactic interventions (odds ratio = 0.10, 95% CI = 0.02 to 0.44) as compared with the placebo/controls. No serious adverse events, such as anaphylactic shock, mortality, and the development of antibiotic-resistant bacteria, were reported. None of the included subjects were of high risk of infectious endocarditis. Our network meta-analysis demonstrates that intravenous amoxicillin/clavulanate and oral amoxicillin might be the best prophylactic interventions in preventing postdental procedure bacteremia among all the oral/topical forms of interventions for the overall populations.
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Affiliation(s)
- B S Zeng
- Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - S Y Lin
- Department of Dentistry, MacKay Memorial Hospital, Taipei, Taiwan
| | - Y K Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Y C Wu
- Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK.,Positive Ageing Research Institute, Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
| | - C S Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - T C Yeh
- Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - T Y Chen
- Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - A F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada
| | - P Y Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - W T Lei
- Division of Allergy, Immunology, Rheumatology Disease, Department of Pediatrics, Mackay Memorial Hospital, Hsinchu, Taiwan
| | - C W Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Y W Chen
- Prospect Clinic for Otorhinolaryngology and Neurology, Kaohsiung City, Taiwan
| | - P T Tseng
- Prospect Clinic for Otorhinolaryngology and Neurology, Kaohsiung City, Taiwan.,WinShine Clinics in Specialty of Psychiatry, Kaohsiung City, Taiwan
| | - C H Chen
- Program in Translational Medicine, National Chung Hsing University, Taichung City, Taiwan.,Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung City, Taiwan.,Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
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25
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Varo C, Murru A, Salagre E, Jiménez E, Solé B, Montejo L, Carvalho AF, Stubbs B, Grande I, Martínez-Arán A, Vieta E, Reinares M. Behavioral addictions in bipolar disorders: A systematic review. Eur Neuropsychopharmacol 2019; 29:76-97. [PMID: 30420190 DOI: 10.1016/j.euroneuro.2018.10.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/18/2018] [Accepted: 10/23/2018] [Indexed: 12/16/2022]
Abstract
Clinical and epidemiological research suggests that behavioral addictions (BA) are associated with a wide range of psychiatric disorders. However, the relationship between BA and bipolar disorders (BD) has not been thoroughly explored. The aim of this systematic review was to critically summarize and evaluate the current available evidence regarding a possible association between BA and BD. A systematic review of major electronic databases according to PRISMA guidelines was conducted from inception to 31st December 2017. We sought quantitative studies data concerning prevalence of comorbidity, features and treatment related to BA-BD comorbidity. Data were narratively synthesized. Of the 1250 studies returned from the search, a total of 28 articles were included in this review. BA may be overrepresented in BD samples, and the other way around. Pathological gambling and kleptomania were the most prevalent conditions followed by compulsive buying, compulsive sexual behavior and internet addiction. BA was also associated with other mood disorders, anxiety disorders and substance use disorder. BD-BA comorbidity was related with more severe course of illness. Studies on treatment strategies for BD-BA comorbidity are rather limited; only one randomized controlled trial that fulfilled inclusion criteria was identified. Methodological heterogeneity in terms of design and results among studies was found. BD-BA commonly co-occurs although there is a need for rigorous studies. Routine screening and adequate assessment may be helpful in BD patients to identify individuals at risk for BA and to effectively manage the complex consequences associated with BA-BD comorbidity.
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Affiliation(s)
- C Varo
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A Murru
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - E Salagre
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Jiménez
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Solé
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - L Montejo
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom
| | - I Grande
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A Martínez-Arán
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Vieta
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - M Reinares
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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26
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Stubbs B. Predictors of hospital admission due to falls and fractures in people with schizophrenia spectrum disorder: a large representative cohort study. Physiotherapy 2019. [DOI: 10.1016/j.physio.2018.11.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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27
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Ruppert J, Hartung D, Westhoff-Bleck M, Herrmann J, Stubbs B, Cordes J, Krüger THC, Lichtinghagen R, Kahl KG. Increased pericardial adipose tissue and cardiometabolic risk in patients with schizophrenia versus healthy controls. Eur Arch Psychiatry Clin Neurosci 2018; 268:719-725. [PMID: 29170826 DOI: 10.1007/s00406-017-0858-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 11/14/2017] [Indexed: 02/07/2023]
Abstract
Patients with schizophrenia are at increased risk of diabetes, cardiovascular disease (CVD) and associated mortality versus the general population. Increased intra-abdominal and pericardial adipose tissue are associated with elevated CVD and mortality in the general population, but little is known about these in patients with schizophrenia. This study examined pericardial and intra-abdominal adipose tissue in schizophrenia and compared this to healthy controls. Thirty-one patients with schizophrenia (mean age 41.2 years, 76% males) and 30 healthy volunteers (CTRL) were examined in this study. The primary outcomes were the volumes of pericardial adipose tissue and intra-abdominal adipose tissue, measured using magnetic resonance imaging. Secondary outcomes included diabetes and cardiac event risk assessed by established instruments. Volumes of pericardial adipose tissue were increased in male and female patients with schizophrenia compared to healthy controls after the adjustment of age, sex and body mass index (P < 0.005). The 10-year risk of a cardiac event was significantly higher in patients with schizophrenia. Furthermore, the risk for developing type-2 diabetes mellitus was slightly increased in schizophrenia. Volumes of intra-abdominal adipose tissue were slightly increased in male and female patients with schizophrenia, albeit not statistically significant. This study demonstrates that patients with schizophrenia have increased pericardial adipose tissue versus controls. This increased fat deposit around the heart is highly relevant for understanding the comorbidity between heart disease and schizophrenia. Interventions aiming to reduce pericardial and intra-abdominal adipose tissue, such as exercise, may be essential to reduce the burden of heart disease in schizophrenia.
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Affiliation(s)
- J Ruppert
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Carl-Neuberg. Str. 1, 30625, Hannover, Germany
| | - D Hartung
- Institute for Diagnostic and Interventional Radiology, MHH, Hannover, Germany
| | - M Westhoff-Bleck
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - J Herrmann
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Carl-Neuberg. Str. 1, 30625, Hannover, Germany
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK.,Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK
| | - J Cordes
- Department of Psychiatry and Psychotherapy, Heinrich-Heine University, Düsseldorf, Germany
| | - T H C Krüger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Carl-Neuberg. Str. 1, 30625, Hannover, Germany
| | - R Lichtinghagen
- Institute for Clinical Chemistry, Hannover Medical School, Hannover, Germany
| | - K G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Carl-Neuberg. Str. 1, 30625, Hannover, Germany.
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28
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Firth J, Stubbs B, Sarris J, Rosenbaum S, Teasdale S, Berk M, Yung AR. The effects of vitamin and mineral supplementation on symptoms of schizophrenia: a systematic review and meta-analysis - CORRIGENDUM. Psychol Med 2018; 48:528. [PMID: 28712367 DOI: 10.1017/s0033291717001866] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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29
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Belbasis L, Köhler CA, Stefanis N, Stubbs B, van Os J, Vieta E, Seeman MV, Arango C, Carvalho AF, Evangelou E. Risk factors and peripheral biomarkers for schizophrenia spectrum disorders: an umbrella review of meta-analyses. Acta Psychiatr Scand 2018; 137:88-97. [PMID: 29288491 DOI: 10.1111/acps.12847] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study aimed to systematically appraise the meta-analyses of observational studies on risk factors and peripheral biomarkers for schizophrenia spectrum disorders. METHODS We conducted an umbrella review to capture all meta-analyses and Mendelian randomization studies that examined associations between non-genetic risk factors and schizophrenia spectrum disorders. For each eligible meta-analysis, we estimated the summary effect size estimate, its 95% confidence and prediction intervals and the I2 metric. Additionally, evidence for small-study effects and excess significance bias was assessed. RESULTS Overall, we found 41 eligible papers including 98 associations. Sixty-two associations had a nominally significant (P-value <0.05) effect. Seventy-two of the associations exhibited large or very large between-study heterogeneity, while 13 associations had evidence for small-study effects. Excess significance bias was found in 18 associations. Only five factors (childhood adversities, cannabis use, history of obstetric complications, stressful events during adulthood, and serum folate level) showed robust evidence. CONCLUSION Despite identifying 98 associations, there is only robust evidence to suggest that cannabis use, exposure to stressful events during childhood and adulthood, history of obstetric complications, and low serum folate level confer a higher risk for developing schizophrenia spectrum disorders. The evidence on peripheral biomarkers for schizophrenia spectrum disorders remains limited.
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Affiliation(s)
- L Belbasis
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - C A Köhler
- Translational Psychiatry Research Group, Department of Clinical Medicine, Federal University of Ceará Medical School, Fortaleza, Brazil
| | - N Stefanis
- Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - B Stubbs
- Department of Physiotherapy, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK
| | - J van Os
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands.,Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - E Vieta
- Bipolar Disorder Unit, Institute of Neuroscience, University of Barcelona, IDIBAPS and CIBERSAM, Barcelona, Spain
| | - M V Seeman
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - C Arango
- Department of Child and Adolescent Psychiatry, University Hospital Gregorio Marañón, Complutense University of Madrid Medical School, CIBERSAM, Madrid, Spain
| | - A F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada
| | - E Evangelou
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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30
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Vancampfort D, Stubbs B, Herring MP, Hallgren M, Koyanagi A. Sedentary behavior and anxiety: Association and influential factors among 42,469 community-dwelling adults in six low- and middle-income countries. Gen Hosp Psychiatry 2018; 50:26-32. [PMID: 28987919 DOI: 10.1016/j.genhosppsych.2017.09.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 09/25/2017] [Accepted: 09/27/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This study investigated the association between sedentary behavior (SB) and anxiety, and explored factors that influence this relationship in six low- and middle-income countries. METHOD Cross-sectional data were analyzed from the World Health Organization's Study on Global Ageing and Adult Health. Multivariable linear and logistic regression analyses were conducted to assess the association between anxiety and self-reported SB. Potentially influential factors were examined with mediation analysis. RESULTS The sample consisted of 42,469 adults aged≥18years (50.1% female; mean age 43.8years). After adjusting for sociodemographics and country, people with anxiety engaged in 24 (95%CI=7-41) more minutes per day of SB than non-anxious individuals; the corresponding figure for the elderly (≥65years) was much higher (55min; 95% CI=29-81). Anxiety was associated with a 2.0 (95%CI=1.5-2.7) times higher odds for high SB (i.e., ≥8h/day). Overall, the largest proportion of the high SB-anxiety relationship was explained by mobility limitations (46.8%), followed by impairments in sleep/energy (44.9%), pain/discomfort (31.7%), disability (27.0%), cognition (13.3%), and physical activity levels (6.3%). CONCLUSIONS Anxiety was significantly associated with high SB, particularly among older adults. Future longitudinal studies are warranted to disentangle the potentially complex interplay of factors that may influence the anxiety-SB relationship.
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Affiliation(s)
- D Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium.
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom
| | - M P Herring
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland
| | - M Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
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Veronese N, Stubbs B, Koyanagi A, Hébert JR, Cooper C, Caruso MG, Guglielmi G, Reginster JY, Rizzoli R, Maggi S, Shivappa N. Pro-inflammatory dietary pattern is associated with fractures in women: an eight-year longitudinal cohort study. Osteoporos Int 2018; 29:143-151. [PMID: 29018920 PMCID: PMC5760322 DOI: 10.1007/s00198-017-4251-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 09/27/2017] [Indexed: 01/17/2023]
Abstract
In this study, during 8 years of follow-up, we reported that higher dietary inflammatory index values were associated with a higher risk of incident fractures in women, but not in men, after adjusting for potential confounders. INTRODUCTION Inflammation is a key risk factor for many adverse outcomes in older people. While diet is a potential source of inflammation, little is known about the impact of inflammatory diet on fractures. Thus, we investigated whether higher Dietary Inflammatory Index (DII)™ ® scores are associated with fractures in a cohort of North American people. METHODS This longitudinal study with a follow-up of 8 years included 3648 participants (1577 males and 2071 females; mean age = 60.6 years) with/at risk of knee osteoarthritis participating with in the Osteoarthritis Initiative. DII scores were calculated using the validated Block Brief 2000 Food Frequency Questionnaire, categorized into sex-specific quintiles. Information on fractures was obtained through self-reported history of fractures at hip, spine, and forearm. The relationship between baseline DII score and incident fracture was assessed through a Cox's regression analysis, adjusted for potential baseline confounders, and reported as hazard ratios (HRs). RESULTS During 8 years of follow-up, 560 individuals developed fractures (15.4%). Adjusting for 10 potential confounders, women in the highest DII score quintile (i.e., most pro-inflammatory diet) had a significantly higher risk for fractures (HR = 1.46; 95% CI = 1.02-2.11) compared to women in the lowest quintile. An increase in one standard deviation of DII scores significantly predicted fracture onset in women (adjusted HR = 1.14; 95% CI = 1.02-1.27). The association between DII score and fractures was not significant among men or in the sample as whole. CONCLUSION Pro-inflammatory diet is associated with a higher incidence of fractures in women but not men.
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Affiliation(s)
- N Veronese
- National Research Council,, Neuroscience Institute, Aging Branch, Via Giustiniani, 2, 35128, Padova, Italy.
- Ambulatory of Nutrition, IRCCS "S. de Bellis", National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy.
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Box SE5 8AF, London, UK
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, CM1 1SQ, UK
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - J R Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Connecting Health Innovations LLC, Columbia, SC, USA
| | - C Cooper
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
- National Institute for Health Research Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - M G Caruso
- Ambulatory of Nutrition, IRCCS "S. de Bellis", National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy
| | - G Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy
- Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia, Italy
| | - J Y Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liege, CHU Sart Tilman B23, 4000, Liège, Belgium
| | - R Rizzoli
- Division of Bone Diseases, Department of Internal Medicine Specialties, and Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - S Maggi
- National Research Council,, Neuroscience Institute, Aging Branch, Via Giustiniani, 2, 35128, Padova, Italy
| | - N Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Connecting Health Innovations LLC, Columbia, SC, USA
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Veronese N, Stubbs B, Solmi M, Smith TO, Reginster JY, Maggi S. Osteoarthristis Increases the Risk of Cardiovascular Disease: Data from the Osteoarthritis Initiative. J Nutr Health Aging 2018; 22:371-376. [PMID: 29484350 DOI: 10.1007/s12603-017-0941-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Although osteoarthritis (OA) is a common condition in older adults, the role of OA in increasing cardiovascular disease (CVD) incidence is still debated. The aim of this study was to investigate the association between OA and the onset of CVD in a large database of American adults. DESIGN Longitudinal. SETTING Community-dwelling. PARTICIPANTS People with OA or at high risk of OA. MEASUREMENTS Osteoarthritis was defined as the presence of OA of the hand, knee, hip, back/neck or of other sites. CVD was defined as self-reported presence of heart attack, heart failure, stroke and other cerebral atherosclerotic conditions, and peripheral artery disease. RESULTS A total 4,265 persons without CVD (mean age=60.8 years, females=59.2%) at baseline were analyzed (1,775 with OA versus 2,490 without). Over a mean of 8.2 years, according to an adjusted Cox's regression analysis for 11 potential baseline confounders, study participants with OA of any joint had a significantly higher risk of developing CVD compared to those without OA (Hazard ratio (HR): =1.27; 95% CI: 1.03-1.56). The presence of hand OA was associated with a higher risk of developing CVD (HR=1.31; 95%CI: 1.01-1.68) with respect to those who had no OA. Knee, hip and back/neck OA did not, instead, increase the risk of developing CVD. The association between OA and CVD was significant in the women, but not in the men. CONCLUSIONS OA, in particular, when it affects the hand and in women, was associated with a higher risk of developing CVD.
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Affiliation(s)
- N Veronese
- Nicola Veronese, MD, National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy, Via Giustiniani, 2 - 35128 Padova, Italy, Phone: +39 04982181746; Fax: +39 0498211218,
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Stubbs B, Vancampfort D, Veronese N, Thompson T, Fornaro M, Schofield P, Solmi M, Mugisha J, Carvalho AF, Koyanagi A. Depression and pain: primary data and meta-analysis among 237 952 people across 47 low- and middle-income countries. Psychol Med 2017; 47:2906-2917. [PMID: 28637534 DOI: 10.1017/s0033291717001477] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Depression and pain are leading causes of global disability. However, there is a paucity of multinational population data assessing the association between depression and pain, particularly among low- and middle-income countries (LMICs) where both are common. Therefore, we investigated this association across 47 LMICs. METHODS Community-based data on 273 952 individuals from 47 LMICs were analysed. Multivariable logistic and linear regression analyses were performed to assess the association between the International Classification of Diseases, 10th Revision depression/depression subtypes (over the past 12 months) and pain in the previous 30 days based on self-reported data. Country-wide meta-analysis adjusting for age and sex was also conducted. RESULTS The prevalence of severe pain was 8.0, 28.2, 20.2, and 34.0% for no depression, subsyndromal depression, brief depressive episode, and depressive episode, respectively. Logistic regression adjusted for socio-demographic variables, anxiety and chronic medical conditions (arthritis, diabetes, angina, asthma) demonstrated that compared with no depression, subsyndromal depression, brief depressive episode, and depressive episode were associated with a 2.16 [95% confidence interval (CI) 1.83-2.55], 1.45 (95% CI 1.22-1.73), and 2.11 (95% CI 1.87-2.39) increase in odds of severe pain, respectively. Similar results were obtained when a continuous pain scale was used as the outcome. Depression was significantly associated with severe pain in 44/47 countries with a pooled odds ratio of 3.93 (95% CI 3.54-4.37). CONCLUSION Depression and severe pain are highly comorbid across LMICs, independent of anxiety and chronic medical conditions. Whether depression treatment or pain management in patients with comorbid pain and depression leads to better clinical outcome is an area for future research.
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Affiliation(s)
- B Stubbs
- Physiotherapy Department,South London and Maudsley NHS Foundation Trust,Denmark Hill, London SE5 8AZ,UK
| | - D Vancampfort
- KU Leuven,Department of Rehabilitation Sciences,Leuven,Belgium
| | - N Veronese
- Geriatrics Division,Department of Medicine-DIMED,University of Padova,Padova,Italy
| | - T Thompson
- Faculty of Education and Health,University of Greenwich,London,UK
| | - M Fornaro
- New York Psychiatric Institute,Columbia University,New York, NY,USA
| | - P Schofield
- Faculty of Health,Social Care and Education,Anglia Ruskin University,Chelmsford,UK
| | - M Solmi
- Institute of clinical Research and Education in Medicine (IREM),Padova,Italy
| | | | - A F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group,Faculty of Medicine,Federal University of Ceará,Fortaleza, CE,Brazil
| | - A Koyanagi
- Research and Development Unit,Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Dr. Antoni Pujadas, 42,Sant Boi de Llobregat,Barcelona 08830,Spain
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Daskalopoulou C, Stubbs B, Kralj C, Koukounari A, Prince M, Prina AM. Physical activity and healthy ageing: A systematic review and meta-analysis of longitudinal cohort studies. Ageing Res Rev 2017. [PMID: 28648951 DOI: 10.1016/j.arr.2017.06.003] [Citation(s) in RCA: 237] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Older people constitute a significant proportion of the total population and their number is projected to increase by more than half by 2030. This increasing probability of late survival comes with considerable individual, economic and social impact. Physical activity (PA) can influence the ageing process but the specific relationship with healthy ageing (HA) is unclear. METHODS We conducted a systematic review and meta-analysis of longitudinal studies examining the associations of PA with HA. Studies were identified from a systematic search across major electronic databases from inception as January 2017. Random-effect meta-analysis was performed to calculate a pooled effect size (ES) and 95% CIs. Studies were assessed for methodological quality. RESULTS Overall, 23 studies were identified including 174,114 participants (30% men) with age ranges from 20 to 87 years old. There was considerable heterogeneity in the definition and measurement of HA and PA. Most of the identified studies reported a significant positive association of PA with HA, six reported a non-significant. Meta-analysis revealed that PA is positively associated with HA (ES: 1.39, 95% CI=1.23-1.57, n=17) even if adjusted for publication bias (ES: 1.27, 95% CI=1.11-1.45, n=20). CONCLUSIONS There is consistent evidence from longitudinal observational studies that PA is positively associated with HA, regardless of definition and measurement. Future research should focus on the implementation of a single metric of HA, on the use of objective measures for PA assessment and on a full-range of confounding adjustment. In addition, our research indicated the limited research on ageing in low-and-middle income countries.
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Affiliation(s)
- C Daskalopoulou
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, London, UK.
| | - B Stubbs
- Department of Health Service and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
| | - C Kralj
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, London, UK
| | - A Koukounari
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - M Prince
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, London, UK
| | - A M Prina
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, London, UK
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Stubbs B, Vancampfort D, Veronese N, Kahl KG, Mitchell AJ, Lin PY, Tseng PT, Mugisha J, Solmi M, Carvalho AF, Koyanagi A. Depression and physical health multimorbidity: primary data and country-wide meta-analysis of population data from 190 593 people across 43 low- and middle-income countries. Psychol Med 2017; 47:2107-2117. [PMID: 28374652 DOI: 10.1017/s0033291717000551] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Despite the known heightened risk and burden of various somatic diseases in people with depression, very little is known about physical health multimorbidity (i.e. two or more physical health co-morbidities) in individuals with depression. This study explored physical health multimorbidity in people with clinical depression, subsyndromal depression and brief depressive episode across 43 low- and middle-income countries (LMICs). METHOD Cross-sectional, community-based data on 190 593 individuals from 43 LMICs recruited via the World Health Survey were analysed. Multivariable logistic regression analysis was done to assess the association between depression and physical multimorbidity. RESULTS Overall, two, three and four or more physical health conditions were present in 7.4, 2.4 and 0.9% of non-depressive individuals compared with 17.7, 9.1 and 4.9% among people with any depressive episode, respectively. Compared with those with no depression, subsyndromal depression, brief depressive episode and depressive episode were significantly associated with 2.62, 2.14 and 3.44 times higher odds for multimorbidity, respectively. A significant positive association between multimorbidity and any depression was observed across 42 of the 43 countries, with particularly high odds ratios (ORs) in China (OR 8.84), Laos (OR 5.08), Ethiopia (OR 4.99), the Philippines (OR 4.81) and Malaysia (OR 4.58). The pooled OR for multimorbidity and depression estimated by meta-analysis across 43 countries was 3.26 (95% confident interval 2.98-3.57). CONCLUSIONS Our large multinational study demonstrates that physical health multimorbidity is increased across the depression spectrum. Public health interventions are required to address this global health problem.
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Affiliation(s)
- B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust,Denmark Hill,London SE5 8AZ,UK
| | - D Vancampfort
- KU Leuven Department of Rehabilitation Sciences,Leuven,Belgium
| | - N Veronese
- Geriatrics Division, Department of Medicine-DIMED,University of Padova,Padova,Italy
| | - K G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy,Hannover Medical School,Hannover,Germany
| | - A J Mitchell
- Department of Cancer and Molecular Medicine,University of Leicester,Leicester,UK
| | - P-Y Lin
- Department of Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan
| | - P-T Tseng
- Department of Psychiatry,Tsyr-Huey Mental Hospital,Kaohsiung Jen-Ai's Home,Taiwan
| | | | - M Solmi
- Department of Neurosciences,University of Padova,Padova,Italy
| | - A F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine,Federal University of Ceará,Fortaleza, CE 60430-040,Brazil
| | - A Koyanagi
- Research and Development Unit,Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu,Dr. Antoni Pujadas, 42,Sant Boi de Llobregat,Barcelona 08830,Spain
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Kouidrat Y, Pizzol D, Cosco T, Thompson T, Carnaghi M, Bertoldo A, Solmi M, Stubbs B, Veronese N. High prevalence of erectile dysfunction in diabetes: a systematic review and meta-analysis of 145 studies. Diabet Med 2017; 34:1185-1192. [PMID: 28722225 DOI: 10.1111/dme.13403] [Citation(s) in RCA: 198] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2017] [Indexed: 12/24/2022]
Abstract
Erectile dysfunction may be common among men with diabetes, but its prevalence is still debated. We aimed to assess the relative prevalence of erectile dysfunction in diabetes searching major databases from inception to November 2016 for studies reporting erectile dysfunction in men with Type 1 and Type 2 diabetes mellitus. We conducted a meta-analysis of the prevalence [and 95% confidence intervals (95% CIs)] of erectile dysfunction in diabetes compared with healthy controls, calculating the relative odds ratios (ORs) and 95% CIs. A random effect model was applied. From 3747 initial hits, 145 studies were included representing 88 577 men (age: 55.8 ± 7.9 years). The prevalence of erectile dysfunction in diabetes overall was 52.5% (95% CI, 48.8 to 56.2) after adjusting for publication bias, and 37.5%, 66.3% and 57.7% in Type 1, Type 2 and both types of diabetes, respectively (P for interaction < 0.0001). The prevalence of erectile dysfunction was highest in studies using the Sexual Health Inventory for Men (82.2%, 17 studies, P for interaction < 0.0001). Studies with a higher percentage of people with hypertension moderated our results (beta = 0.03; 95% CI, 0.008 to 0.040; P = 0.003; R2 = 0.00). Compared to healthy controls (n = 5385) men with diabetes (n = 863) were at increased odds of having erectile dysfunction (OR 3.62; 95% CI, 2.53 to 5.16; P < 0.0001; I2 = 67%, k = 8). Erectile dysfunction is common in diabetes, affecting more than half of men with the condition and with a prevalence odds of approximately 3.5 times more than controls. Our findings suggest that screening and appropriate intervention for men with erectile dysfunction is warranted.
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Affiliation(s)
- Y Kouidrat
- Department of Nutrition, Maritime Hospital of Berck, France
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
| | - D Pizzol
- Operational Research Unit, Doctors with Africa Cuamm, Beira, Mozambique
| | - T Cosco
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
- Oxford Institute of Population Ageing, University of Oxford, London, UK
| | - T Thompson
- Faculty of Education and Health, University of Greenwich, London, UK
| | - M Carnaghi
- Operational Research Unit, Doctors with Africa Cuamm, Beira, Mozambique
| | - A Bertoldo
- Zerouno Procreazione, Centro di Medicina, Venezia Mestre, Padova, Italy
| | - M Solmi
- Department of Neurosciences, University of Padova, Padova, Italy
- Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy
| | - B Stubbs
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
| | - N Veronese
- Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
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Firth J, Stubbs B, Sarris J, Rosenbaum S, Teasdale S, Berk M, Yung AR. The effects of vitamin and mineral supplementation on symptoms of schizophrenia: a systematic review and meta-analysis. Psychol Med 2017; 47:1515-1527. [PMID: 28202095 DOI: 10.1017/s0033291717000022] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND When used as an adjunctive with antipsychotics, certain vitamins and minerals may be effective for improving symptomatic outcomes of schizophrenia, by restoring nutritional deficits, reducing oxidative stress, or modulating neurological pathways. METHOD We conducted a systematic review of all randomized controlled trials (RCTs) reporting effects of vitamin and/or mineral supplements on psychiatric symptoms in people with schizophrenia. Random-effects meta-analyses were used to calculate the standardized mean difference between nutrient and placebo treatments. RESULTS An electronic database search in July 2016 identified 18 eligible RCTs, with outcome data for 832 patients. Pooled effects showed that vitamin B supplementation (including B6, B8 and B12) reduced psychiatric symptoms significantly more than control conditions [g = 0.508, 95% confidence interval (CI) 0.01-1.01, p = 0.047, I 2 = 72.3%]. Similar effects were observed among vitamin B RCTs which used intention-to-treat analyses (g = 0.734, 95% CI 0.00-1.49, p = 0.051). However, no effects of B vitamins were observed in individual domains of positive and negative symptoms (both p > 0.1). Meta-regression analyses showed that shorter illness duration was associated with greater vitamin B effectiveness (p = 0.001). There were no overall effects from antioxidant vitamins, inositol or dietary minerals on psychiatric symptoms. CONCLUSIONS There is preliminary evidence that certain vitamin and mineral supplements may reduce psychiatric symptoms in some people with schizophrenia. Further research is needed to examine how the benefits of supplementation relate to nutrient deficits and the impact upon underlying neurobiological pathways, in order to establish optimal nutrient formulations for improving clinical outcomes in this population. Future studies should also explore the effects of combining beneficial nutrients within multi-nutrient formulas.
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Affiliation(s)
- J Firth
- Division of Psychology and Mental Health,University of Manchester,Manchester,UK
| | - B Stubbs
- Physiotherapy Department,South London and Maudsley NHS Foundation Trust, London,UK
| | - J Sarris
- Department of Psychiatry,University of Melbourne, The Melbourne Clinic,Melbourne,Australia
| | - S Rosenbaum
- Department of Exercise Physiology,School of Medical Sciences,Faculty of Medicine,University of New South Wales,Sydney,Australia
| | - S Teasdale
- Keeping the Body in Mind Program,South Eastern Sydney Local Health District,Sydney,Australia
| | - M Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine,Victoria,Australia
| | - A R Yung
- Division of Psychology and Mental Health,University of Manchester,Manchester,UK
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Köhler CA, Freitas TH, Maes M, de Andrade NQ, Liu CS, Fernandes BS, Stubbs B, Solmi M, Veronese N, Herrmann N, Raison CL, Miller BJ, Lanctôt KL, Carvalho AF. Peripheral cytokine and chemokine alterations in depression: a meta-analysis of 82 studies. Acta Psychiatr Scand 2017; 135:373-387. [PMID: 28122130 DOI: 10.1111/acps.12698] [Citation(s) in RCA: 823] [Impact Index Per Article: 117.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/29/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis of studies that measured cytokine and chemokine levels in individuals with major depressive disorder (MDD) compared to healthy controls (HCs). METHOD The PubMed/MEDLINE, EMBASE, and PsycINFO databases were searched up until May 30, 2016. Effect sizes were estimated with random-effects models. RESULT Eighty-two studies comprising 3212 participants with MDD and 2798 HCs met inclusion criteria. Peripheral levels of interleukin-6 (IL-6), tumor necrosis factor (TNF)-alpha, IL-10, the soluble IL-2 receptor, C-C chemokine ligand 2, IL-13, IL-18, IL-12, the IL-1 receptor antagonist, and the soluble TNF receptor 2 were elevated in patients with MDD compared to HCs, whereas interferon-gamma levels were lower in MDD (Hedge's g = -0.477, P = 0.043). Levels of IL-1β, IL-2, IL-4, IL-8, the soluble IL-6 receptor (sIL-6R), IL-5, CCL-3, IL-17, and transforming growth factor-beta 1 were not significantly altered in individuals with MDD compared to HCs. Heterogeneity was large (I2 : 51.6-97.7%), and sources of heterogeneity were explored (e.g., age, smoking status, and body mass index). CONCLUSION Our results further characterize a cytokine/chemokine profile associated with MDD. Future studies are warranted to further elucidate sources of heterogeneity, as well as biosignature cytokines secreted by other immune cells.
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Affiliation(s)
- C A Köhler
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - T H Freitas
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - M Maes
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong, Australia.,Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Department of Psychiatry, Faculty of Medicine, State University of Londrina, Londrina, PR, Brazil.,Department of Psychiatry, Medical University Plovdiv, Plovdiv, Bulgaria.,Revitalis, Waalre, The Netherlands
| | - N Q de Andrade
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - C S Liu
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.,Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program Sunnybrook Research Institute, Toronto, ON, Canada
| | - B S Fernandes
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong, Australia.,Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK.,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - M Solmi
- Department of Neurosciences, University of Padova, Padova, Italy.,Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy
| | - N Veronese
- Department of Neurosciences, University of Padova, Padova, Italy.,Department of Medicine, DIMED, Geriatrics Section, University of Padova, Padova, Italy
| | - N Herrmann
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program Sunnybrook Research Institute, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - C L Raison
- Department of Human Development and Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, WI, USA.,Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - B J Miller
- Department of Psychiatry & Health Behavior, Augusta University, Augusta, GA, USA
| | - K L Lanctôt
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.,Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program Sunnybrook Research Institute, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - A F Carvalho
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
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Solmi M, Veronese N, Beatrice B, Stella R, Paolo S, Davide G, Collantoni E, Pigato G, Favaro A, Stubbs B, Carvalho A, Vacampfort D, Correll C. Prevalence, incidence and comparative meta-analysis of all-cause and specific-cause cardiovascular disease in patients with serious mental illness. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.02.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Patients with severe mental illness (SMI) have been described at higher risk of cardiovascular disease (CVD). The aim of this systematic review and meta-analysis was to quantify prevalence, incidence, cross-sectional association and longitudinal increased risk of coronary heart disease (CHD), stroke, transient ischemic attack and cerebrovascular disease (CBVD), heart failure (HF), peripheral vascular disease (PVD), death due to CVD, and any CVD in patients with SMI. We included 92 studies, with a total population of 3,371,461 patients (BD = 241,226, MDD = 476,102, SCZ = 1,721,586, SMI = 932,547) and 113,925,577 controls. Pooled prevalence of any CVD in SMI was 9.9% (95% CI = 7.4–13.3) (33 studies, 360,144 patients). Compared to controls, after adjusting for a median of 7 confounders, SMI was associated with higher risk of CVD in cross-sectional studies, OR:1.53 (95% CI = 1.27–1.83) (11 studies), with CHD OR: 1.51 (95% CI = 1.47–1.55) (5 studies), with CBVD OR: 1.42 (95% CI = 1.21–1.66) (6 studies), and tended to be associated with HF OR: 1.28 (95% CI = 0.99–1.65) (4 studies). Cumulative incidence was 3.6 CVD events in a median follow-up period of 8.4 years (range: 1.76–30). After considering a median of 6 confounders, SMI was associated with higher longitudinal risk of CVD in longitudinal studies HR: 1.78 (95% CI = 1.6, 1.98) (31 studies), of CHD: HR: 1.54 (95% CI 1.30–1.82) (18 studies), of CBVD HR: 1.64 (95% CI 1.26–2.14) (11 studies), of HF HR:2.10 (95% CI 1.64–2.70) (2 studies), of PVD, unadjusted RR: 3.11 (95% CI 2.46–3.91) (3 studies), of death due to CVD, HR 1.85 (95% CI 1.53–2.24) (16 studies). In this meta-analysis, the association between SMI and CVD has been quantified in a world representative sample; we suggest prevention of CVD should be warranted as standard care in SMI.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Veronese N, Sergi G, Stubbs B, Bourdel-Marchasson I, Tessier D, Sieber C, Strandberg T, Gillain S, Barbagallo M, Crepaldi G, Maggi S, Manzato E. Effect of acetyl-l-carnitine in the treatment of diabetic peripheral neuropathy: A systematic review and meta-analysis. Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2017.01.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Koyanagi A, Oh H, Stubbs B, Haro JM, DeVylder JE. Epidemiology of depression with psychotic experiences and its association with chronic physical conditions in 47 low- and middle-income countries. Psychol Med 2017; 47:531-542. [PMID: 27786151 DOI: 10.1017/s0033291716002750] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND The co-existence of depression and psychotic experiences (PEs) is associated with more pronounced adverse health outcomes compared to depression alone. However, data on its prevalence and correlates are lacking in the general adult population, and there is no published data on its association with chronic physical conditions. METHOD Cross-sectional, community-based data from 201 337 adults aged ⩾18 years from 47 low- and middle-income countries from the World Health Survey were analyzed. The presence of past 12-month PE and DSM-IV depression was assessed with the Composite International Diagnostic Interview (CIDI). Information on six chronic medical conditions (chronic back pain, edentulism, arthritis, angina, asthma, diabetes) were obtained by self-report. Multivariable logistic regression analysis was performed. RESULTS The crude overall prevalence of co-morbid depression/PEs was 2.5% [95% confidence interval (CI) 2.3-2.7%], with the age- and sex-adjusted prevalence ranging from 0.1% (Sri Lanka, Vietnam) to 9.03% (Brazil). Younger age, urban setting, current smoking, alcohol consumption, and anxiety were significant correlates of co-existing depression/PEs. Co-occurring depression/PEs was associated with significantly higher odds for arthritis, angina, and diabetes beyond that of depression alone after adjusting for sociodemographics, anxiety, and country, with odds ratios (depression/PEs v. depression only) being: arthritis 1.30 (95% CI 1.07-1.59, p = 0.0086); angina 1.40 (95% CI 1.18-1.67, p = 0.0002); diabetes 1.65 (95% CI 1.21-2.26, p = 0.0017). CONCLUSIONS The prevalence of co-existing depression/PEs was non-negligible in most countries. Our study suggests that when depression/PE or a chronic condition (e.g. arthritis, angina, diabetes) is detected, screening for the other may be important to improve clinical outcomes.
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Affiliation(s)
- A Koyanagi
- Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Barcelona,Spain
| | - H Oh
- University of California Berkeley School of Public Health,Berkeley,CA,USA
| | - B Stubbs
- Physiotherapy Department,South London and Maudsley NHS Foundation Trust,Denmark Hill,London,UK
| | - J M Haro
- Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Barcelona,Spain
| | - J E DeVylder
- School of Social Work,University of Maryland,Baltimore, MD,USA
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Kahl KG, Herrmann J, Stubbs B, Krüger THC, Cordes J, Deuschle M, Schweiger U, Hüper K, Helm S, Birkenstock A, Hartung D. Pericardial adipose tissue and the metabolic syndrome is increased in patients with chronic major depressive disorder compared to acute depression and controls. Prog Neuropsychopharmacol Biol Psychiatry 2017; 72:30-35. [PMID: 27528109 DOI: 10.1016/j.pnpbp.2016.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 07/18/2016] [Accepted: 08/08/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Major depressive disorder (MDD) is associated with an estimated fourfold risk for premature death, largely attributed to cardiovascular disorders. Pericardial adipose tissue (PAT), a fat compartment surrounding the heart, has been implicated in the development of coronary artery disease. An unanswered question is whether people with chronic MDD are more likely to have elevated PAT volumes versus acute MDD and controls (CTRL). METHODS The study group consists of sixteen patients with chronic MDD, thirty-four patients with acute MDD, and twenty-five CTRL. PAT and adrenal gland volume were measured by magnetic resonance tomography. Additional measures comprised factors of the metabolic syndrome, cortisol, relative insulin resistance, and pro-inflammatory cytokines (interleukin-6; IL-6 and tumor necrosis factor-α, TNF-α). RESULTS PAT volumes were significantly increased in patients with chronic MDD>patients with acute MDD>CTRL. Adrenal gland volume was slightly enlarged in patients with chronic MDD>acute MDD>CTRL, although this difference failed to reach significance. The PAT volume was correlated with adrenal gland volume, and cortisol concentrations were correlated with depression severity, measured by BDI-2 and MADRS. Group differences were found concerning the rate of the metabolic syndrome, being most frequent in chronic MDD>acute MDD>CTRL. Further findings comprised increased fasting cortisol, increased TNF-α concentration, and decreased physical activity level in MDD compared to CTRL. CONCLUSION Our results extend the existing literature in demonstrating that patients with chronic MDD have the highest risk for developing cardiovascular disorders, indicated by the highest PAT volume and prevalence of metabolic syndrome. The correlation of PAT with adrenal gland volume underscores the role of the hypothalamus-pituitary-adrenal system as mediator for body-composition changes. Metabolic monitoring, health advices and motivation for the improvement of physical fitness may be recommended in depressed patients, in particular in chronic depression.
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Affiliation(s)
- K G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany.
| | - J Herrmann
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, United Kingdom
| | - T H C Krüger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany
| | - J Cordes
- Department of Psychiatry and Psychotherapy, Heinrich-Heine University, Düsseldorf, Germany
| | - M Deuschle
- Central Institute of Mental Health, Mannheim, Germany
| | - U Schweiger
- Dep. of Psychiatry and Psychotherapy, University of Lübeck, Germany
| | - K Hüper
- Institute for Diagnostic and Interventional Radiology, MHH, Hannover, Germany
| | - S Helm
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany
| | - A Birkenstock
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany
| | - D Hartung
- Institute for Diagnostic and Interventional Radiology, MHH, Hannover, Germany
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Fornaro M, Stubbs B, De Berardis D, Iasevoli F, Solmi M, Veronese N, Carano A, Perna G, De Bartolomeis A. Does the " Silver Bullet" Lose its Shine Over the Time? Assessment of Loss of Lithium Response in a Preliminary Sample of Bipolar Disorder Outpatients. Clin Pract Epidemiol Ment Health 2016; 12:142-157. [PMID: 28217142 PMCID: PMC5278557 DOI: 10.2174/1745017901612010142] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/03/2016] [Accepted: 10/08/2016] [Indexed: 01/14/2023]
Abstract
Background: Though often perceived as a “silver bullet” treatment for bipolar disorder (BD), lithium has seldom reported to lose its efficacy over the time. Objective: The aim of the present study was to assess cases of refractoriness toward restarted lithium in BD patients who failed to preserve maintenance. Method: Treatment trajectories associated with re-instituted lithium following loss of achieved lithium-based maintenance in BD were retrospectively reviewed for 37 BD-I patients (median age 52 years; F:M=17:20 or 46% of the total) over an 8.1-month period on average. Results: In our sample only 4 cases (roughly 11% of the total, of whom F:M=2:2) developed refractoriness towards lithium after its discontinuation. Thirty-three controls (F:M=15:18) maintained lithium response at the time of re-institution. No statistically significant difference between cases and controls was observed with respect to a number of demographic and clinical features but for time spent before first trial ever with lithium in life (8.5 vs. 3 years; U=24.5, Z=-2.048, p=.041) and length of lithium discontinuation until new therapeutic attempt (5.5 vs. 2 years; U=8, Z=-2.927, p=.003) between cases vs. controls respectively. Tapering off of lithium was significantly faster among cases vs. controls (1 vs. 7 days; U=22, Z=-2.187), though both subgroups had worrisome high rates of poor adherence overall. Conclusion: Although intrinsic limitations of the present preliminary assessment hamper the validity and generalizability of overall results, stating the clinical relevance of the topic further prospective research is warranted. The eventual occurrence of lithium refractoriness may indeed be associated with peculiar course trajectories and therapeutic outcomes ultimately urging the prescribing clinicians to put efforts in preserving maintenance of BD in the absence of any conclusive research insight on the matter.
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Affiliation(s)
- M Fornaro
- New York State Psychiatric Institute (NYPSI); Columbia University, NYC, NY, USA
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK; Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - D De Berardis
- National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, "G. Mazzini" Hospital, ASL 4 Teramo, Italy
| | - F Iasevoli
- Outpatient Unit on Treatment Resistant Psychosis, Department of Neuroscience, University School of Medicine Federico II, Naples, Italy
| | - M Solmi
- Department of Neurosciences, University of Padova, Padova, Italy; I.R.E.M. (Institute for clinical Research and Education in Medicine), Padova, Italy
| | - N Veronese
- I.R.E.M. (Institute for clinical Research and Education in Medicine), Padova, Italy; Geriatrics Section, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - A Carano
- Hospital "C. G. Mazzoni", Ascoli Piceno, Italy
| | - G Perna
- Department of Clinical Neurosciences, Hermanas Hospitalarias, FoRiPsi, Villa San Benedetto Menni, Albese con Cassano, 22032 Como, Italy; Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, Netherlands; Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, Miami University, Miami, FL 33136, USA
| | - A De Bartolomeis
- Outpatient Unit on Treatment Resistant Psychosis, Department of Neuroscience, University School of Medicine Federico II, Naples, Italy
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Veronese N, Watutantrige-Fernando S, Luchini C, Solmi M, Sartore G, Sergi G, Manzato E, Barbagallo M, Maggi S, Stubbs B. Effect of magnesium supplementation on glucose metabolism in people with or at risk of diabetes: a systematic review and meta-analysis of double-blind randomized controlled trials. Eur J Clin Nutr 2016; 70:1463. [PMID: 27924111 DOI: 10.1038/ejcn.2016.209] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Stubbs B, Koyanagi A, Schuch FB, Firth J, Rosenbaum S, Veronese N, Solmi M, Mugisha J, Vancampfort D. Physical activity and depression: a large cross-sectional, population-based study across 36 low- and middle-income countries. Acta Psychiatr Scand 2016; 134:546-556. [PMID: 27704532 DOI: 10.1111/acps.12654] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/09/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Physical activity (PA) is good for health, yet several small-scale studies have suggested that depression is associated with low PA. A paucity of nationally representative studies investigating this relationship exists, particularly in low- and middle-income countries (LMICs). This study explored the global association of PA with depression and its mediating factors. METHOD Participants from 36 LMICs from the World Health Survey were included. Multivariable logistic regression analyses were undertaken exploring the relationship between PA and depression. RESULTS Across 178 867 people (mean ± SD age = 36.2 ± 13.5 years; 49.9% male), the prevalence of depression and the prevalence of low PA were 6.6% and 16.8% respectively. The prevalence of low PA was significantly higher among those with depression vs. no depression (26.0% vs. 15.8%, P < 0.0001). In the adjusted model, depression was associated with higher odds for low PA (OR = 1.42; 95% CI = 1.24-1.63). Mediation analyses demonstrated that low PA among people with depression was explained by mobility limitations (40.3%), pain and discomfort (35.8%), disruptions in sleep and energy (25.2%), cognition (19.4%) and vision (10.9%). CONCLUSION Individuals with depression engage in lower levels of PA in LMICs. Future longitudinal research is warranted to better understand the relationships observed.
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Affiliation(s)
- B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - F B Schuch
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - J Firth
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - S Rosenbaum
- Department of Exercise Physiology, School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - N Veronese
- Geriatrics Division, Department of Medicine-DIMED, University of Padova, Italy, Institute of clinical Research and Education in Medicine (IREM), Padova, Italy
| | - M Solmi
- Department of Neurosciences, University of Padova, Padova, Italy
| | - J Mugisha
- Kyambogo University, Kampala, Uganda.,Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - D Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.,KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
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Hallgren M, Stubbs B, Vancampfort D, Lundin A, Jääkallio P, Forsell Y. Treatment guidelines for depression: Greater emphasis on physical activity is needed. Eur Psychiatry 2016; 40:1-3. [PMID: 27837666 DOI: 10.1016/j.eurpsy.2016.08.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 08/24/2016] [Accepted: 08/26/2016] [Indexed: 12/27/2022] Open
Affiliation(s)
- M Hallgren
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK
| | - D Vancampfort
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium
| | - A Lundin
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - P Jääkallio
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Y Forsell
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
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Lucato P, Trevisan C, Stubbs B, Zanforlini BM, Solmi M, Luchini C, Girotti G, Pizzato S, Manzato E, Sergi G, Giannini S, Fusaro M, Veronese N. Nephrolithiasis, bone mineral density, osteoporosis, and fractures: a systematic review and comparative meta-analysis. Osteoporos Int 2016; 27:3155-3164. [PMID: 27289533 DOI: 10.1007/s00198-016-3658-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/27/2016] [Indexed: 01/14/2023]
Abstract
UNLABELLED Our meta-analysis demonstrates that people with nephrolithiasis have decreased bone mineral density, an increased odds of osteoporosis, and potentially an elevated risk of fractures. INTRODUCTION People with nephrolithiasis might be at risk of reduced bone mineral density (BMD) and fractures, but the data is equivocal. We conducted a meta-analysis to investigate if patients with nephrolithiasis have worse bone health outcomes (BMD), osteoporosis, and fractures versus healthy controls (HCs). METHODS Two investigators searched major databases for articles reporting BMD (expressed as g/cm2 or a T- or Z-score), osteoporosis or fractures in a sample of people with nephrolithiasis, and HCs. Standardized mean differences (SMDs), 95 % confidence intervals (CIs) were calculated for BMD parameters; in addition odds (ORs) for case-control and adjusted hazard ratios (HRs) in longitudinal studies for categorical variables were calculated. RESULTS From 1816 initial hits, 28 studies were included. A meta-analysis of case-control studies including 1595 patients with nephrolithiasis (mean age 41.1 years) versus 3402 HCs (mean age 40.2 years) was conducted. Patients with nephrolithiasis showed significant lower T-scores values for the spine (seven studies; SMD = -0.69; 95 % CI = -0.86 to -0.52; I 2 = 0 %), total hip (seven studies; SMD = -0.82; 95 % CI = -1.11 to -0.52; I 2 = 72 %), and femoral neck (six studies; SMD = -0.67; 95 % CI = --1.00 to -0.34; I 2 = 69 %). A meta-analysis of the case-controlled studies suggests that people with nephrolithiasis are at increased risk of fractures (OR = 1.15, 95 % CI = 1.12-1.17, p < 0.0001, studies = 4), while the risk of fractures in two longitudinal studies demonstrated trend level significance (HR = 1.31, 95 % CI = 0.95-1.62). People with nephrolithiasis were four times more likely to have osteoporosis than HCs (OR = 4.12, p < 0.0001). CONCLUSIONS Nephrolithiasis is associated with lower BMD, an increased risk of osteoporosis, and possibly, fractures. Future screening/preventative interventions targeting bone health might be indicated.
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Affiliation(s)
- P Lucato
- Department of Medicine - DIMED, Geriatrics Division, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy
| | - C Trevisan
- Department of Medicine - DIMED, Geriatrics Division, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, Box, SE5 8 AF, London, UK
| | - B M Zanforlini
- Department of Medicine - DIMED, Geriatrics Division, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy
| | - M Solmi
- Department of Neurosciences, University of Padova, Padova, Italy
- Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy
| | - C Luchini
- Department of Pathology and Diagnostics, Verona University and Hospital Trust, Verona, Italy
- Azienda Provinciale per i Servizi Sanitari (APSS) Trento, Trento, Italy
| | - G Girotti
- Department of Medicine - DIMED, Geriatrics Division, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy
| | - S Pizzato
- Department of Medicine - DIMED, Geriatrics Division, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy
| | - E Manzato
- Department of Medicine - DIMED, Geriatrics Division, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy
- National Research Council, Aging Branch, Institute of Neuroscience, Padova, Italy
| | - G Sergi
- Department of Medicine - DIMED, Geriatrics Division, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy
| | - S Giannini
- Department of Medicine, Clinica Medica I, University of Padova, Padova, Italy
| | - M Fusaro
- National Research Council (CNR), Neuroscience Institute, Padova, Italy
| | - N Veronese
- Department of Medicine - DIMED, Geriatrics Division, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy.
- Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy.
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Vancampfort D, Mugisha J, Richards J, De Hert M, Lazzarotto AR, Schuch FB, Probst M, Stubbs B. Dropout from physical activity interventions in people living with HIV: a systematic review and meta-analysis. AIDS Care 2016; 29:636-643. [PMID: 27794625 DOI: 10.1080/09540121.2016.1248347] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Physical activity (PA) interventions have been shown to improve the health of people living with HIV (PLWH), yet treatment dropout poses an important challenge. We conducted a meta-analysis to investigate the prevalence and predictors of treatment dropout in PA interventions in PLWH. Electronic databases were searched for records up to September 2016. Randomized control trials of PA interventions in PLWH reporting dropout rates were included. Random effects meta-analysis and meta-regression analyses were employed. In 36 studies involving 49 PA intervention arms, 1128 PLWH were included (mean age = 41.6 years; 79.3% male; 39% White). The trim and fill adjusted treatment dropout rate was 29.3% (95% CI = 24.5-34.7%). There was a significant lower dropout rate in resistance training interventions compared with aerobic (p = 0.003) PA interventions, in studies utilizing supervised interventions throughout the study period (p < 0.001), and in studies using adequately qualified professionals (p < 0.001). Exerciser/participant variables that moderated higher dropout rates were a lower percentage of male participants (β = 1.15, standard error (SE) = 0.49, z = 2.0, p = 0.048), a lower body mass index(BMI) (β = 0.14, SE = 0.06, z = 2.16, p = 0.03), and a lower cardiorespiratory fitness (β = 0.10, SE = 0.04, z = 2.7, p = 0.006). The dropout from PA interventions is much higher in PLWH than in many other populations with chronic morbidities. Qualified professionals (i.e., exercise physiologists, physical educators, or physical therapists) should be incorporated as key care providers in the multidisciplinary care of HIV/AIDS and should prescribe supervised PA for PLWH in order to enhance adherence and reduce the burden of HIV/AIDS. Special attention should be given men, those with a higher BMI, and those with a lower cardiorespiratory fitness.
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Affiliation(s)
- D Vancampfort
- a Department of Rehabilitation Sciences , KU Leuven - University of Leuven , Leuven , Belgium.,b University Psychiatric Center KU Leuven, KU Leuven - University of Leuven , Leuven-Kortenberg , Belgium
| | - J Mugisha
- c Butabika National Referral and Mental Health Hospital , Kampala , Uganda.,d Department of Sociology and Social Administration , Kyambogo University , Kampala , Uganda
| | - J Richards
- e School of Public Health & Charles Perkins Centre , University of Sydney , Sydney , NSW , Australia
| | - M De Hert
- b University Psychiatric Center KU Leuven, KU Leuven - University of Leuven , Leuven-Kortenberg , Belgium
| | | | - F B Schuch
- g Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil
| | - M Probst
- a Department of Rehabilitation Sciences , KU Leuven - University of Leuven , Leuven , Belgium
| | - B Stubbs
- h Physiotherapy Department , South London and Maudsley NHS Foundation Trust , London , UK.,i Health Service and Population Research Department , Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park , London , UK
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Firth J, Rosenbaum S, Stubbs B, Gorczynski P, Yung AR, Vancampfort D. Motivating factors and barriers towards exercise in severe mental illness: a systematic review and meta-analysis. Psychol Med 2016; 46:2869-2881. [PMID: 27502153 PMCID: PMC5080671 DOI: 10.1017/s0033291716001732] [Citation(s) in RCA: 235] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 06/23/2016] [Accepted: 06/24/2016] [Indexed: 12/23/2022]
Abstract
Exercise can improve clinical outcomes in people with severe mental illness (SMI). However, this population typically engages in low levels of physical activity with poor adherence to exercise interventions. Understanding the motivating factors and barriers towards exercise for people with SMI would help to maximize exercise participation. A search of major electronic databases was conducted from inception until May 2016. Quantitative studies providing proportional data on the motivating factors and/or barriers towards exercise among patients with SMI were eligible. Random-effects meta-analyses were undertaken to calculate proportional data and 95% confidence intervals (CI) for motivating factors and barriers toward exercise. From 1468 studies, 12 independent studies of 6431 psychiatric patients were eligible for inclusion. Meta-analyses showed that 91% of people with SMI endorsed 'improving health' as a reason for exercise (N = 6, n = 790, 95% CI 80-94). Among specific aspects of health and well-being, the most common motivations were 'losing weight' (83% of patients), 'improving mood' (81%) and 'reducing stress' (78%). However, low mood and stress were also identified as the most prevalent barriers towards exercise (61% of patients), followed by 'lack of support' (50%). Many of the desirable outcomes of exercise for people with SMI, such as mood improvement, stress reduction and increased energy, are inversely related to the barriers of depression, stress and fatigue which frequently restrict their participation in exercise. Providing patients with professional support to identify and achieve their exercise goals may enable them to overcome psychological barriers, and maintain motivation towards regular physical activity.
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Affiliation(s)
- J. Firth
- Institute of Brain, Behaviour and Mental
Health, University of Manchester,
UK
| | - S. Rosenbaum
- Department of Exercise Physiology,
School of Medical Sciences, Faculty of
Medicine, University of New South Wales,
Australia
| | - B. Stubbs
- Physiotherapy Department,
South London and Maudsley NHS Foundation Trust,
UK
- Health Service and Population Research
Department, Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
UK
| | - P. Gorczynski
- Department of Sport and Exercise
Science, University of Portsmouth,
UK
| | - A. R. Yung
- Institute of Brain, Behaviour and Mental
Health, University of Manchester,
UK
- Orygen Youth Health Research Centre,
University of Melbourne, Australia
| | - D. Vancampfort
- KU Leuven Department of Rehabilitation
Sciences, Leuven, Belgium
- KU Leuven Department of Neurosciences,
UPC KU Leuven, Belgium
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Taylor J, Mahmoodi N, Stubbs B, Lewis H, Hosali P, Hewitt C, Smith R, Wright J, McDermid K, Kayalackakom T, Keller I, Ajjan R, Alderson S, Hughes T, Holt R, Siddiqi N. P15 Improving diabetes outcomes in severe mental illness: A systematic review and meta-analysis of pharmacological and non-pharmacological interventions. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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