The epidemiological burden of major psychiatric disorders (original) (raw)
Related papers
World Psychiatry, 2023
Empirical evidence indicates a significant bidirectional association between mental disorders and physical diseases, but the prospective impact of men tal disorders on clinical outcomes of physical diseases has not been comprehensively outlined. In this PRISMA and COSMOSEcompliant umbrella review, we searched PubMed, PsycINFO, Embase, and Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, up to March 15, 2022, to identify systematic reviews with metaanalysis that examined the prospective association between any mental disorder and clinical outcomes of physical diseases. Primary outcomes were diseasespecific mortality and allcause mortality. Secondary outcomes were diseasespecific incidence, functioning and/or disability, symptom severity, quality of life, recurrence or progression, major cardiac events, and treatmentrelated out comes. Additional inclusion criteria were further applied to primary studies. Random effect models were employed, along with I 2 statistic, 95% predic tion intervals, smallstudy effects test, excess significance bias test, and risk of bias (ROBIS) assessment. Associations were classified into five credibility classes of evidence (I to IV and nonsignificant) according to established criteria, complemented by sensitivity and subgroup analyses to examine the robustness of the main analysis. Statistical analysis was performed using a new package for conducting umbrella reviews (https://metaumbrella.org). Population attributable fraction (PAF) and generalized impact fraction (GIF) were then calculated for class IIII associations. Fortyseven systematic reviews with metaanalysis, encompassing 251 nonoverlapping primary studies and reporting 74 associations, were included (68% were at low risk of bias at the ROBIS assessment). Altogether, 43 primary outcomes (diseasespecific mortality: n=17; allcause mortality: n=26) and 31 secondary outcomes were investigated. Although 72% of associations were statistically significant (p<0.05), only two showed convincing (class I) evidence: that between depressive disorders and allcause mortality in patients with heart failure (
Measures of effect in epidemiological research
2010
The study of the relationship between risk factors and outcomes is important both in etiological and prognostic research. To assess the strength of a given risk factor-outcome relationship we use measures that are calculated in relative and absolute terms. Risk ratio, incidence rate ratio and odds ratio are relative measures of this relationship. Risk difference (or attributable risk) and rate difference (or attributable rate) are absolute measures of the same relationship. Risk difference and rate difference are calculated by subtracting the risk and the incidence rate in exposed individuals from that in unexposed individuals, respectively. The choice of these measures depends on the study aim. Relative measures are commonly used in etiological studies while absolute measures are mainly used in public health research.
Sao Paulo Medical Journal, 2014
CONTEXT AND OBJECTIVE: Case-control studies are important in developing clinical and public health knowledge. The STROBE statement (STrengthening the Reporting of OBservational Studies in Epidemiology) was developed to establish a checklist of items that should be included in articles reporting observational studies. Our aim was to analyze whether the psychiatric case-control articles published in Brazilian journals with CAPES Qualis rating B1/B2 in 2009 conformed with the STROBE statement. DESIGN AND SETTING: Descriptive study on psychiatric papers published in Brazilian journals, within the Postgraduate Medical Program on Psychiatry, at Universidade Federal do Rio Grande do Sul. METHODS: All psychiatric case-control studies from Brazilian Qualis B1/B2 journals of psychiatry, neurology and public health in 2009 were analyzed. The four most specific items of the STROBE statement were used to evaluate whether these studies fitted within the case-control parameters: 1) selection of cases and controls; 2) controlling for bias; 3) statistical analysis; and 4) presentation of results. RESULTS: Sixteen case-control studies were identified, of which eleven (68.75%) were in psychiatryfocused journals. From analysis using the STROBE statement, all of the articles conformed with item 1; two (12.5%) completely conformed with item 2; none completely conformed with item 3; and only three (18.8%) conformed with item 4. CONCLUSION: The case-control studies analyzed here did not completely conform with the four STROBE statement items for case-control design. In view of the inadequate methodology of the published studies, these findings justify focusing on research and methodology and expanding the investigations on adherence of studies to their designs. RESUMO CONTEXTO E OBJETIVO: Estudos de caso-controle são importantes no desenvolvimento do conhecimento clínico e de saúde pública. O STROBE statement (STrengthening the Reporting of OBservational Studies in Epidemiology) foi criado para estabelecer uma lista de itens que devem estar presentes na descrição de estudos observacionais. Nosso objetivo é analisar a adequação de artigos caso-controle psiquiátricos publicados em periódicos brasileiros Qualis B1/B2 CAPES em 2009 utilizando o STROBE statement. TIPO DE ESTUDO E LOCAL: Estudo descritivo de artigos em psiquiatria publicados por periódicos brasileiros, realizado no Programa de Pós-Graduação em Medicina: Psiquiatria, na Universidade Federal do Rio Grande do Sul. MÉTODOS: Todos os estudos de caso-controle psiquiátricos em revistas brasileiras Qualis B1/B2 de psiquiatria, neurologia e saúde pública em 2009 foram analisados. Os quatro itens mais específicos do STRO-BE statement foram utilizados para avaliar se os estudos se ajustavam aos parâmetros de caso-controle: 1) seleção de casos e controles, 2) controle de vieses, 3) análise estatística e 4) apresentação dos resultados. RESULTADOS: Dezesseis estudos de caso-controle foram identificados, 68,75% (11) deles de periódicos de psiquiatria. Após a análise com base no STROBE statement, todos os artigos adequavam-se ao item 1; 12,5% (2) adequavam-se completamente ao item 2; nenhum ajustava-se completamente ao item 3; e somente 18,8% (3) estavam adequados em relação ao item 4. CONCLUSÃO: Os estudos de caso-controle avaliados aqui não se adequaram completamente aos quatro itens do STROBE statement para o desenho de caso-controle. Tendo em vista a inadequada metodologia dos estudos publicados, os achados justificam direcionar-se o foco para a pesquisa e metodologia, aumentando a investigação da adesão dos estudos aos seus desenhos.