Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-26T06:11:34.669Z Has data issue: false hasContentIssue false
  • English
  • Français

Disparities in the management of cardiovascular risk factors in patients with psychiatric disorders: a systematic review and meta-analysis

Published online by Cambridge University Press:  01 March 2018

Luis Ayerbe ,
Ivo Forgnone ,
Quintí Foguet-Boreu ,
Esteban González ,
Juliet Addo  and
Salma Ayis
Luis Ayerbe*
Affiliation:
Centre of Primary Care and Public Health, Queen Mary University of London, London, UK
Ivo Forgnone
Affiliation:
Daroca Primary Care Centre, Madrid, Spain
Quintí Foguet-Boreu
Affiliation:
Department of Psychiatry, Vic University Hospital, Vic, Spain
Esteban González
Affiliation:
Family Medicine Unit, Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
Juliet Addo
Affiliation:
Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
Salma Ayis
Affiliation:
Division of Health and Social Care Research, Kings College London, London, UK
*
Author for correspondence: Luis Ayerbe, E-mail: l.garcia-morzon@qmulac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The high cardiovascular (CV) morbidity and mortality reported for patients with psychiatric disorders may possibly be due to a poorer management of CV risk factors (CVRFs). However, these healthcare disparities remain poorly understood. In this paper, studies comparing the management of smoking, diabetes, hypertension and dyslipidaemia, in patients with and without depression, anxiety, schizophrenia, bipolar or personality disorder, were reviewed.

Methods

Prospective studies comparing rates of screening, diagnosis, treatment and control of CVRFs were searched in PubMed, Embase, PsychInfo, Scopus and Web of Science (inception to January 2017). The Meta-analysis of Observational Studies in Epidemiology (MOOSE) criteria were used. Studies were assessed for quality. Wherever possible, meta-analyses were conducted to summarize the findings.

Results

Twenty studies, out of the 18 333 references initially identified, were included. Most studies were heterogeneous in design. Two areas permitted meta-analyses: the pooled odds ratio for quitting smoking for those with depression was 0.64 (0.49–0.80) p < 0.001; the pooled difference of glycated haemoglobin for patients with type 2 diabetes and depression was 0.18 (0.06–0.31) p = 0.005. Individual studies showed associations between: schizophrenia and lower probability of having smoking habit recorded; schizoid personality disorder and higher probability of remaining non-smokers after quitting; anxiety and poorer control of type I diabetes; depression, anxiety or schizophrenia and lower probability of having a diagnosis of hypertension; schizophrenia or bipolar disorder and lower use of antihypertensive and lipid-lowering drugs.

Conclusions

A proactive clinical management, together with further studies, are needed to reduce the CV morbidity and mortality of patients with psychiatric disorders.

Keywords

Healthcare disparitiescardiovascular diseasesmental disordersrisk factorsmeta-analysis
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 16 , December 2018 , pp. 2693 - 2701
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Altman, DG and Bland, JM (2011) How to obtain the confidence interval from a p value. British Medical Journal 343, d2090.Google Scholar
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington DCGoogle Scholar
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th edn. Washington DCGoogle Scholar
Anda, RF, Williamson, DF, Escobedo, LG, Mast, EE, Giovino, GA and Remington, PL (1990) Depression and the dynamics of smoking. A national perspective. Journal of the American Medical Association 264, 1541–1545.Google Scholar
Ayerbe, L, Forgnone, I, Addo, J, Siguero, A, Gelati, S and Ayis, S (2018) Hypertension risk and clinical care in patients with bipolar disorder or schizophrenia; a systematic review and meta-analysis. Journal of Affective Disorders 225, 665–670.Google Scholar
Baller, JB, McGinty, EE, Azrin, ST, Juliano-Bult, D and Daumit, GL (2015) Screening for cardiovascular risk factors in adults with serious mental illness: a review of the evidence. BMC Psychiatry 15, 55.Google Scholar
Besson, M and Forget, B (2016) Cognitive dysfunction, affective states, and vulnerability to nicotine addiction: a multifactorial perspective. Frontal Psychiatry 7, 160.Google Scholar
Borenstein, M, Hedges, LV, Higgins, JPT and Rothstein, HR (2009) Introduction to Meta-Analysis. New York: John Wiley & Sons.Google Scholar
Bot, M, Pouwer, F, de Jonge, P, Tack, CJ, Geelhoed-Duijvestijn, PH and Snoek, FJ (2013) Differential associations between depressive symptoms and glycaemic control in outpatients with diabetes. Diabetes Medicine 30, 115–122.Google Scholar
Breslau, N, Peterson, EL, Schultz, LR, Chilcoat, HD and Andreski, P (1998) Major depression and stages of smoking. A longitudinal investigation. Archives of General Psychiatry 55, 161–166.Google Scholar
Byrd, JB, Powers, JD, Magid, DJ, Tavel, HM, Schmittdiel, JA, OConnor, PJ et al. (2012) Detection and recognition of hypertension in anxious and depressed patients. Journal of Hypertension 30, 2293–2298.Google Scholar
Chaiton, MO, Cohen, JE, O'Loughlin, J and Rehm, J (2009) A systematic review of longitudinal studies on the association between depression and smoking in adolescents. BMC Public Health 9, 356.Google Scholar
Chen, S, Zhang, Q, Dai, G, Hu, J, Zhu, C, Su, L et al. (2016) Association of depression with pre-diabetes, undiagnosed diabetes, and previously diagnosed diabetes: a meta-analysis. Endocrine 53(1), 35–46.Google Scholar
Colton, CW and Manderscheid, RW (2006) Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Preventing Chronic Diseases 3(2), A42.Google Scholar
Cooper, J, Borland, R, McKee, SA, Yong, HH and Dugue, PA (2016) Depression motivates quit attempts but predicts relapse: differential findings for gender from the international tobacco control study. Addiction 111, 1438–1447.Google Scholar
Correll, CU, Detraux, J, De Lepeleire, J and De Hert, M (2015) Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. World Psychiatry 14, 119–136.Google Scholar
de Groot, M, Anderson, R, Freedland, KE, Clouse, RE and Lustman, PJ (2001) Association of depression and diabetes complications: a meta-analysis. Psychosomatic Medicine 63, 619–630.Google Scholar
De Hert, M, Correll, CU, Bobes, J, Cetkovich-Bakmas, M, Cohen, D, Asai, I et al. (2011) Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry 10(1), 52–77.Google Scholar
De Leon, J and Diaz, FJ (2005) A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors. Schizophrenia Research 76, 135–157.Google Scholar
Der Simonian, R and Kacker, R (2007) Random-effects model for meta-analysis of clinical trials: an update. Contemporary Clinical Trials 28, 105–114.Google Scholar
Dong, JY, Zhang, YH, Tong, J and Qin, LQ (2012) Depression and risk of stroke: a meta-analysis of prospective studies. Stroke 43, 32–37.Google Scholar
Dwyer, T, Couper, D and Walter, SD (2001) Sources of heterogeneity in the meta-analysis of observational studies. The example of SIDS and sleeping position. Journal of Clinical Epidemiology 54, 440–447.Google Scholar
Egede, LE and Dismuke, CE (2012) Serious psychological distress and diabetes: a review of the literature. Current Psychiatry Reports 14, 15–22.Google Scholar
Fan, Z, Wu, Y, Shen, J, Ji, T and Zhan, R (2013) Schizophrenia and the risk of cardiovascular diseases: a meta-analysis of thirteen cohort studies. Journal of Psychiatry Research 47, 1549–1556.Google Scholar
Fond, G, Guillaume, S, Artero, S, Bernard, P, Ninot, G, Courtet, P et al. (2013) Self-reported major depressive symptoms at baseline impact abstinence prognosis in smoking cessation program. A one-year prospective study. Journal of Affective Disorders 149, 418–421.Google Scholar
George, TP, Wu, BS and Weinberger, AH (2012) A review of smoking cessation in bipolar disorder: implications for future research. Journal of Dual Diagnosis 8, 126–130.Google Scholar
Goldberg, EL, Comstock, GW and Graves, CG (1980) Psychosocial factors and blood pressure. Psychological Medicine 10, 243–255.Google Scholar
Heckbert, SR, Rutter, CM, Oliver, M, Williams, LH, Ciechanowski, P, Lin, EH et al. (2010) Depression in relation to long-term control of glycemia, blood pressure, and lipids in patients with diabetes. Journal of General Internal Medicine 25, 524–529.Google Scholar
Heffner, JL, Strawn, JR, DelBello, MP, Strakowski, SM and Anthenelli, RM (2011) The co-occurrence of cigarette smoking and bipolar disorder: phenomenology and treatment considerations. Bipolar Disorders 13, 439–453.Google Scholar
Higgins, JP, (2008) Commentary: Heterogeneity in meta-analysis should be expected and appropriately quantified. International Journal of Epidemiology 37, 1158–1160.Google Scholar
Higgins, JP, Thompson, SG, Deeks, JJ and Altman, DG (2003) Measuring inconsistency in meta-analyses. British Medical Journal 327, 557–560.Google Scholar
Hilliard, ME, Herzer, M, Dolan, LM and Hood, KK (2011) Psychological screening in adolescents with type 1 diabetes predicts outcomes one year later. Diabetes Research and Clinical Practice 94, 39–44.Google Scholar
Hitsman, B, Borrelli, B, McChargue, DE, Spring, B and Niaura, R (2003) History of depression and smoking cessation outcome: a meta-analysis. Journal of Consulting Clinical Psychology 71, 657–663.Google Scholar
Jiang, F, Li, S, Pan, L, Zhang, N and Jia, C (2014) Association of anxiety disorders with the risk of smoking behaviors: a meta-analysis of prospective observational studies. Drug Alcohol Dependence 145, 69–76.Google Scholar
Kaufman, EA, McDonell, MG, Cristofalo, MA and Ries, RK (2012) Exploring barriers to primary care for patients with severe mental illness: frontline patient and provider accounts. Issues on Mental Health Nursing 33, 172–180.Google Scholar
Kostev, K, Dippel, FW and Rathmann, W (2016) Predictors of early discontinuation of basal insulin therapy in type 2 diabetes in primary care. Primary Care Diabetes 10, 142–147.Google Scholar
Lahti, M, Tiihonen, J, Wildgust, H, Beary, M, Hodgson, R, Kajantie, E et al. (2012) Cardiovascular morbidity, mortality and pharmacotherapy in patients with schizophrenia. Psychological Medicine 42, 2275–2285.Google Scholar
Laursen, TM, Mortensen, PB, MacCabe, JH, Cohen, D and Gasse, C (2014) Cardiovascular drug use and mortality in patients with schizophrenia or bipolar disorder: a Danish population-based study. Psychological Medicine 44, 1625–1637.Google Scholar
Leucht, S, Burkard, T, Henderson, J, Maj, M and Sartorius, N (2007) Physical illness and schizophrenia: a review of the literature. Acta Psychiatrica Scandinavica 116, 317–333.Google Scholar
Lord, O, Malone, D and Mitchell, AJ (2010) Receipt of preventive medical care and medical screening for patients with mental illness: a comparative analysis. General Hospital Psychiatry 32, 519–543.Google Scholar
Lustman, PJ, Anderson, RJ, Freedland, KE, de Groot, M, Carney, RM and Clouse, RE (2000) Depression and poor glycemic control: a meta-analytic review of the literature. Diabetes Care 23, 934–942.Google Scholar
Mangurian, C, Newcomer, JW, Modlin, C and Schillinger, D (2016) Diabetes and cardiovascular care among people with severe mental illness: a literature review. Journal of General Internal Medicine 31, 1083–1091.Google Scholar
Mathew, AR, Hogarth, L, Leventhal, AM, Cook, JW and Hitsman, B (2017) Cigarette smoking and depression comorbidity: systematic review and proposed theoretical model. Addiction 112(3), 401–412.Google Scholar
McGinty, EE, Baller, J, Azrin, ST, Juliano-Bult, D and Daumit, GL (2015) Quality of medical care for persons with serious mental illness: a comprehensive review. Schizophrenia Research 165, 227–235.Google Scholar
Meng, L, Chen, D, Yang, Y, Zheng, Y and Hui, R (2012) Depression increases the risk of hypertension incidence: a meta-analysis of prospective cohort studies. Journal of Hypertension 30, 842–851.Google Scholar
Mitchell, AJ, Malone, D and Doebbeling, CC (2009) Quality of medical care for people with and without comorbid mental illness and substance misuse: systematic review of comparative studies. British Journal of Psychiatry 194, 491–499.Google Scholar
Mitchell, AJ, Lord, O and Malone, D (2012) Differences in the prescribing of medication for physical disorders in individuals with v. Without mental illness: meta-analysis. British Journal of Psychiatry 20, 435–443.Google Scholar
Mitchell, AJ, Vancampfort, D, De Hert, M and Stubbs, B (2015) Do people with mental illness receive adequate smoking cessation advice? A systematic review and meta-analysis. General Hospital Psychiatry 37, 14–23.Google Scholar
Mitchell, AJ, Yadegarfar, M, Gill, J and Stubbs, B (2016) Case finding and screening clinical utility of the patient health questionnaire (PHQ-9 and PHQ-2) for depression in primary care: a diagnostic meta-analysis of 40 studies. British Journal of Psychiatry Open 2, 127–138.Google Scholar
Musselman, DL, Ziemer, DC, McNutt, MD, Seay, JS, Royster, EB, Larsen, B et al. (2014) Depression, deficits in functional capacity, and impaired glycemic control in urban African Americans with type 2 diabetes. Journal of Psychiatry Research 52, 21–27.Google Scholar
National Institute of Health (2016) Quality assessment tool for Observational Cohort and Cross-sectional studies Available at http://www.nhlbi.nih.gov/health-pro/guidelines/in-develop/cardiovascular-risk-reduction/tools/cohort (Accessed October 2016).Google Scholar
National Institute for Health and Care Excellence (2009) Depression in adults: the treatment and management of depression in adults. Available at http://www.nice.org.uk/guidance/cg90/chapter/about-this-guideline (Accessed October 2017).Google Scholar
National Institute of Health and Care Excellence (2011) Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults: management in primary, secondary and community care. Available at http://www.nice.org.uk/guidance/CG113/chapter/Key-priorities-for-implementation (Accessed October 2017).Google Scholar
National Institute for Health and Care Excellence (2016 a) Cardiovascular disease prevention. Available at http://pathways.nice.org.uk/pathways/cardiovascular-disease-prevention (Accessed February 2016).Google Scholar
National Institute for Health and Care Excellence (2016 b) Hypertension in adults: diagnosis and management. Available at https://www.nice.org.uk/guidance/cg127 (Accessed October 2017).Google Scholar
National Institute for Health and Care Excellence (2017 a). Smoking. Available at https://pathways.nice.org.uk/pathways/smoking. (Accessed April 2017).Google Scholar
National institute of Health and Care Excellence (2017 b) Type I diabetes in adults. Available at https://pathways.nice.org.uk/pathways/type-1-diabetes-in-adults. (Accessed March 2017).Google Scholar
National Institute for Health and Care Excellence (2017 c) Type 2 Diabetes in Adults. Available at https://pathways.nice.org.uk/pathways/type-2-diabetes-in-adults. (Accessed March 2017).Google Scholar
Oud, MJ and Meyboom-de Jong, B (2009) Somatic diseases in patients with schizophrenia in general practice: their prevalence and health care. BMC Family Practice 10, 32.Google Scholar
Pan, Y, Cai, W, Cheng, Q, Dong, W, An, T and Yan, J (2015) Association between anxiety and hypertension: a systematic review and meta-analysis of epidemiological studies. Neuropsychiatric Disease Treatment 11, 1121–1130.Google Scholar
Perez-Pinar, M, Mathur, R, Foguet, Q, Ayis, S, Robson, J and Ayerbe, L (2016) Cardiovascular risk factors among patients with schizophrenia, bipolar, depressive, anxiety, and personality disorders. European Psychiatry 35, 8–15.Google Scholar
Perez-Pinar, M, Ayerbe, L, González, E, Mathur, R, Foguet-Boreu, Q and Ayis, S (2017) Anxiety disorders and risk of stroke: a systematic review and meta-analysis. European Psychiatry 41, 102–108.Google Scholar
Pineiro, B, Fernandez Del Rio, E, Lopez-Duran, A, Martinez, U and Becona, E (2013) The association between probable personality disorders and smoking cessation and maintenance. Addictive Behaviours 38, 2369–2373.Google Scholar
Prieto, ML, Cuellar-Barboza, AB, Bobo, WV, Roger, VL, Bellivier, F, Leboyer, M et al. (2014) Risk of myocardial infarction and stroke in bipolar disorder: a systematic review and exploratory meta-analysis. Acta Psychiatrica Scandinavica 130, 342–353.Google Scholar
Richardson, LK, Egede, LE, Mueller, M, Echols, CL and Gebregziabher, M (2008) Longitudinal effects of depression on glycemic control in veterans with type 2 diabetes. General Hospital Psychiatry 30, 509–514.Google Scholar
Roberts, L, Roalfe, A, Wilson, S and Lester, H (2007) Physical health care of patients with schizophrenia in primary care: a comparative study. Family Practice 24, 34–40.Google Scholar
Roest, AM, Martens, EJ, de Jonge, P and Denollet, J (2010) Anxiety and risk of incident coronary heart disease: a meta-analysis. Journal of the American College of Cardiology 56, 38–46.Google Scholar
Salvi, V, Grua, I, Cerveri, G, Mencacci, C and Barone-Adesi, F (2017) The risk of new-onset diabetes in antidepressant users – A systematic review and meta-analysis. PLoS ONE 12(7), e0182088.Google Scholar
Simonsick, EM, Wallace, RB, Blazer, DG and Berkman, LF (1995) Depressive symptomatology and hypertension-associated morbidity and mortality in older adults. Psychosomatic Medicine 57, 427–435.Google Scholar
Steele, F (2005). Event History Analysis. ESRC National Centre for Research Methods Briefing Paper, NCRM Methods Review Papers (NCRM/004). Bristol: University of Bristol.Google Scholar
Stepankova, L, Kralikova, E, Zvolska, K, Kmetova, A, Blaha, M, Bortlicek, Z et al. (2013). Tobacco treatment outcomes in patients with and without a history of depression, Czech Republic, 2005-2010. Preventing Chronic Diseases 10, E158.Google Scholar
Stroup, DF, Berlin, JA, Morton, SC, Olkin, I, Williamson, GD, Rennie, D et al. (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283, 2008–2012.Google Scholar
Vancampfort, D, Mitchell, AJ, De Hert, M, Sienaert, P, Probst, M, Buys, R et al. (2015) Type 2 diabetes in patients with major depressive disorder: a meta-analysis of prevalence estimates and predictors. Depression and Anxiety 32, 763–773.Google Scholar
Vancampfort, D, Correll, CU, Galling, B, Probst, M, De Hert, M, Ward, PB et al. (2016) Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: a systematic review and large scale meta-analysis. World Psychiatry 15, 166–174.Google Scholar
Van der Kooy, K, van Hout, H, Marwijk, H, Marten, H, Stehouwer, C and Beekman, A (2007) Depression and the risk for cardiovascular diseases: systematic review and meta analysis. International Journal of Geriatric Psychiatry 22, 613–626.Google Scholar
Viron, MJ, and Stern, TA (2010) The impact of serious mental illness on health and healthcare. Psychosomatics 51, 458–465.Google Scholar
Viron, M, Baggett, T, Hill, M and Freudenreich, O (2012) Schizophrenia for primary care providers: how to contribute to the care of a vulnerable patient population. American Journal of Medicine 125, 223–230.Google Scholar
Walker, ER, McGee, RE and Druss, BG (2015) Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry 72, 334–341.Google Scholar
Wang, PS, Avorn, J, Brookhart, MA, Mogun, H, Schneeweiss, S, Fischer, MA et al. (2005) Effects of noncardiovascular comorbidities on antihypertensive use in elderly hypertensives. Hypertension 46, 273–279.Google Scholar
World Health Organization (1978) International Statistical Classification of Diseases and Related Health Problems (ICD-9). Available at http://www.who.int/classifications/icd/en/ (Accessed November 2017).Google Scholar
World Health Organization (2010) International Statistical Classification of Diseases and Related Health Problems 10th Revision. ICD10. Available at http://apps.who.int/classifications/icd10/browse/2010/en (Accessed November 2017).Google Scholar
Wu, Q and Kling, JM (2016) Depression and the risk of myocardial infarction and coronary death: a meta-analysis of prospective cohort studies. Medicine 95(6), e2815.Google Scholar
Zhu, SH, Sun, J, Billings, SC, Choi, WS and Malarcher, A (1999) Predictors of smoking cessation in U.S. Adolescents. American Journal of Preventive Medicine 16, 202–207.Google Scholar
Supplementary material: File

Ayerbe et al. supplementary material

Ayerbe et al. supplementary material 1

Download Ayerbe et al. supplementary material(File)
File 42.4 KB