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多种疾病与自杀意念的关系:一项荟萃分析。

The relationship between multimorbidity and suicidal ideation: A meta-analysis.

机构信息

School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; NHC Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China.

School of Public Health, Nanjing Medical University, Nanjing 211166, China.

出版信息

J Psychosom Res. 2020 Nov;138:110257. doi: 10.1016/j.jpsychores.2020.110257. Epub 2020 Sep 22.

Abstract

OBJECTIVE

Multimorbidity refers to the individual has two or more medical conditions, which include physical multimorbidity (two or more physical conditions), mental multimorbidity (two or more mental conditions) and physical and mental multimorbidity (one or more mental and one or more physical conditions). This study is to assess the relationship between multimorbidity and suicidal ideation (SI) by conducting a meta-analysis.

METHODS

Through using subject word and random word, Web of Science, Cochrane Library and PubMed were searched for related records up to March 2020. The Newcastle-Ottawa scale and the Agency for Healthcare Research and Quality were used to evaluate the quality of included studies. Subgroup and sensitivity analysis were performed. The publication bias was evaluated by the funnel plots, Begg's test and Egger's test.

RESULTS

A total of 19 studies were included for analysis. The pooled odd ratio (OR) for the association between multimorbidity and SI was 2.90 (95%CI 2.29-3.67, P < .001). Subgroup analysis based on nature of study, category of multimorbidity, country, whether adjusted the covariates, and quality ratings was performed. The result of sensitivity analysis indicated that no individual studies had a substantial impact on the pooled OR. There was no publication bias in the studies.

CONCLUSIONS

Multimorbidity is one important factor in increased risk of SI. It is critical to assessing SI among patients with multimorbidity in primary care and specialty medical practices, particularly among physical and mental multimorbidity patients who may have higher risk of SI.

摘要

目的

多病共存是指个体同时患有两种或两种以上疾病,包括躯体多病共存(两种或两种以上躯体疾病)、精神多病共存(两种或两种以上精神疾病)以及躯体-精神多病共存(一种或多种精神疾病和一种或多种躯体疾病)。本研究旨在通过荟萃分析评估多病共存与自杀意念(SI)之间的关系。

方法

通过使用主题词和自由词,检索了截至 2020 年 3 月的 Web of Science、Cochrane 图书馆和 PubMed 中的相关记录。使用纽卡斯尔-渥太华量表和医疗保健研究与质量局评估纳入研究的质量。进行了亚组和敏感性分析。通过漏斗图、贝格检验和埃格检验评估发表偏倚。

结果

共纳入 19 项研究进行分析。多病共存与 SI 之间关联的合并优势比(OR)为 2.90(95%CI 2.29-3.67,P<.001)。基于研究性质、多病共存类别、国家、是否调整协变量以及质量评分进行了亚组分析。敏感性分析的结果表明,没有单个研究对合并 OR 有重大影响。研究中不存在发表偏倚。

结论

多病共存是增加 SI 风险的一个重要因素。在初级保健和专科医疗实践中评估多病共存患者的 SI 至关重要,特别是躯体-精神多病共存患者,他们可能具有更高的 SI 风险。

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