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心理健康住院部儿童和青少年的临床和行为心血管代谢风险:系统评价和荟萃分析。

The clinical and behavioral cardiometabolic risk of children and young people on mental health inpatient units: A systematic review and meta-analysis.

机构信息

Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK; Division of Psychology and Mental Health, University of Manchester, Manchester, UK.

Division of Psychology and Mental Health, University of Manchester, Manchester, UK; NICM Health Research Institute, Western Sydney University, Westmead, Australia.

出版信息

Gen Hosp Psychiatry. 2021 May-Jun;70:80-97. doi: 10.1016/j.genhosppsych.2021.03.007. Epub 2021 Mar 15.

Abstract

OBJECTIVE

Serious mental illness is associated with physical health comorbidities, however most research has focused on adults. We aimed to synthesise existing literature on clinical and behavioral cardiometabolic risk factors of young people on mental health inpatient units.

METHODS

A systematic review and meta-analysis was conducted, using electronic searches of PsycINFO, EMBASE, AMED, Cochrane Central Register of Controlled Trials, and Ovid MEDLINE. Eligible studies included child/adolescent mental health inpatient units for <25 years, reporting clinical/behavioral cardiometabolic risk factors. Studies containing adult samples, case-studies, or eating disorder populations were excluded. The main clinical outcome was weight, and main behavioral outcome was tobacco use.

RESULTS

Thirty-nine studies were identified (n = 809,185). Pooled prevalence rates of young people who were overweight (BMI > 25) was 32.4% (95% CI 26.1%-39.5%; n = 2789), and who were obese (BMI > 30) was 15.5% (95% CI 4.5%-41.6%; n = 2612). Pooled prevalence rates for tobacco use was 51.5% (95% CI 32.2-70.2; N = 804,018). Early signs of metabolic risk were observed; elevated blood cholesterol, presence of physical health conditions, and behavioral risk factors (e.g. physical inactivity).

CONCLUSIONS

This review highlights the vulnerability of young people admitted to inpatient units and emphasises the opportunity to efficiently monitor, treat and intervene to target physical and mental health.

摘要

目的

严重的精神疾病与身体健康合并症有关,但大多数研究都集中在成年人身上。我们旨在综合现有文献,了解精神科住院患者的年轻人的临床和行为心血管代谢风险因素。

方法

进行了系统的文献回顾和荟萃分析,使用了电子搜索 PsycINFO、EMBASE、AMED、Cochrane 对照试验中心注册和 Ovid MEDLINE。符合条件的研究包括儿童/青少年精神科住院患者,年龄<25 岁,报告临床/行为心血管代谢风险因素。包含成人样本、病例研究或饮食失调人群的研究被排除在外。主要临床结果是体重,主要行为结果是吸烟。

结果

确定了 39 项研究(n=809185)。超重(BMI>25)的年轻人的汇总患病率为 32.4%(95%CI 26.1%-39.5%;n=2789),肥胖(BMI>30)的患病率为 15.5%(95%CI 4.5%-41.6%;n=2612)。吸烟的汇总患病率为 51.5%(95%CI 32.2-70.2;n=804018)。观察到代谢风险的早期迹象,包括血液胆固醇升高、身体健康状况和行为风险因素(如身体活动不足)。

结论

本综述强调了住院患者年轻人的脆弱性,并强调了有效监测、治疗和干预以针对身心健康的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1534/8135692/b6d8fa289f40/gr1.jpg

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