Lee Hyeri, Lee Jun Hyuk, Lee Subin, Lim Ji Soo, Kim Hyeon Jin, Park Jaeyu, Lee Hayeon, Fond Guillaume, Boyer Laurent, Smith Lee, Rahmati Masoud, Tully Mark A, Pizzol Damiano, Oh Hans, Kang Jiseung, Yon Dong Keon
Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
Department of Regulatory Science, Kyung Hee University, Seoul, South Korea.
Mol Psychiatry. 2025 Mar;30(3):1127-1137. doi: 10.1038/s41380-024-02792-2. Epub 2024 Oct 18.
There is no comprehensive umbrella review exploring the connection between schizophrenia and various health outcomes. Therefore, we aimed to systematically review existing meta-analyses about schizophrenia-associated comorbid health outcomes and validate the evidence levels. We performed an umbrella review of meta-analyses of observational studies to explore comorbid health outcomes in individuals with schizophrenia. Searches were conducted across PubMed/MEDLINE, EMBASE, ClinicalKey, and Google Scholar up to September 5, 2023, targeting meta-analyses of observational studies related to comorbid health outcomes in individuals with schizophrenia. We applied AMSTAR2 for data extraction and quality assessment, adhering to PRISMA guidelines. Evidence credibility was evaluated and categorized by evidence quality. Our protocol was registered with PROSPERO (CRD42024498833). Risk and protective factors were analyzed and presented through equivalent odds ratios (eRR). In this umbrella review, we analyzed 9 meta-analyses, including 88 original articles, covering 21 comorbid health outcomes with over 66 million participants across 19 countries. Patients with schizophrenia showed significant associations with multiple health outcomes, including asthma (eRR, 1.71 [95% CI, 1.05-2.78], class and quality of evidence [CE] = non-significant), chronic obstructive pulmonary disease (1.73 [1.25-2.37], CE = weak), pneumonia (2.63 [1.11-6.23], CE = weak), breast cancer of female patients (1.31 [1.04-1.65], CE = weak), cardiovascular disease (1.53 [1.12-2.11], CE = weak), stroke (1.71 [1.30-2.25], CE = weak), congestive heart failure (1.81 [1.21-2.69], CE = weak), sexual dysfunction (2.30 [1.75-3.04], CE = weak), fracture (1.63 [1.10-2.40], CE = weak), dementia (2.29 [1.19-4.39], CE = weak), and psoriasis (1.83 [1.18-2.83] CE = weak). Our study underscores the imperative for an integrated treatment approach to schizophrenia, highlighting its broad impact across respiratory, cardiovascular, sexual, neurological, and dermatological health domains. Given the predominantly non-significant to weak evidence levels, further studies are needed to reinforce our understanding.
目前尚无全面的伞状综述探讨精神分裂症与各种健康结局之间的联系。因此，我们旨在系统回顾现有的关于精神分裂症相关合并健康结局的荟萃分析，并验证证据水平。我们对观察性研究的荟萃分析进行了伞状综述，以探讨精神分裂症患者的合并健康结局。截至2023年9月5日，在PubMed/MEDLINE、EMBASE、ClinicalKey和谷歌学术上进行了检索，目标是与精神分裂症患者合并健康结局相关的观察性研究的荟萃分析。我们应用AMSTAR2进行数据提取和质量评估，遵循PRISMA指南。根据证据质量对证据可信度进行评估和分类。我们的方案已在PROSPERO（CRD42024498833）注册。通过等效优势比（eRR）分析并呈现风险和保护因素。在本次伞状综述中，我们分析了9项荟萃分析，包括88篇原始文章，涵盖21种合并健康结局，涉及19个国家的6600多万参与者。精神分裂症患者与多种健康结局存在显著关联，包括哮喘（eRR，1.71[95%CI，1.05 - 2.78]，证据类别和质量[CE]=不显著）、慢性阻塞性肺疾病（1.73[1.25 - 2.37]，CE=弱）、肺炎（2.63[1.11 - 6.23]，CE=弱）、女性患者乳腺癌（1.31[1.04 - 1.65]，CE=弱）、心血管疾病（1.53[1.12 - 2.11]，CE=弱）、中风（1.71[1.30 - 2.25]，CE=弱）、充血性心力衰竭（1.81[1.21 - 2.69]，CE=弱）、性功能障碍（2.30[1.75 - 3.04]，CE=弱）、骨折（1.63[1.10 - 2.40]，CE=弱）、痴呆（2.29[1.19 - 4.39]，CE=弱）和银屑病（1.83[1.18 - 2.83]，CE=弱）。我们的研究强调了对精神分裂症采取综合治疗方法的必要性，突出了其对呼吸、心血管、性、神经和皮肤健康领域的广泛影响。鉴于证据水平主要为不显著至弱，需要进一步研究以加强我们的理解。
