精神障碍与中风风险之间的关联：队列研究的荟萃分析
Association between psychiatric disorders and the risk of stroke: a meta-analysis of cohort studies.
作者信息
Hu Zhonghou, Sun Weishan, Cui Enxiu, Chen Bo, Zhang Mi
机构信息
Third Department of Psychiatry, Yancheng Fourth People's Hospital, Yancheng, China.
出版信息
Front Neurol. 2024 Dec 18;15:1444862. doi: 10.3389/fneur.2024.1444862. eCollection 2024.
BACKGROUND
Psychiatric disorders may be associated with an elevated risk of stroke; however, the existence of variations in this association between different populations remains controversial. Consequently, we conducted a comprehensive systematic review and meta-analysis to examine the magnitude of the relationship between psychiatric disorders and the risk of stroke.
METHODS
The PubMed, Embase, and Cochrane Library databases were systematically searched to identify eligible studies from inception to April 2024. The aggregated findings were expressed as relative risks (RRs) with 95% confidence intervals (CIs), and the combined analysis was performed using a random-effects modeling approach. Further exploratory analyses were also performed using sensitivity and subgroup analyses.
RESULTS
A total of 36 cohort studies, involving 25,519,635 individuals, were selected for analysis. We noted that depression (RR: 1.50; 95% CI: 1.34-1.68; < 0.001), schizophrenia (RR: 1.74; 95% CI: 1.36-2.24; < 0.001), and bipolar disorder (RR: 1.65; 95% CI: 1.27-2.14; < 0.001) were associated with an elevated risk of stroke. Further exploratory analyses found that the association between depression and the risk of stroke differed according to the adjusted level (RR ratio: 0.77; 95% CI: 0.61-0.98; = 0.034), and the association between schizophrenia and the risk of stroke differed according to the outcome definition (RR ratio: 0.68; 95% CI: 0.52-0.90; = 0.006). Moreover, the association between bipolar disorder and the risk of stroke differed according to the study design (RR ratio: 0.68; 95% CI: 0.55-0.84; < 0.001).
CONCLUSION
The significant association between psychiatric disorders and an elevated risk of stroke highlights the importance of enhanced monitoring and stroke prevention in patients with psychiatric disorders.
SYSTEMATIC REVIEW REGISTRATION
Our study was registered on the INPLASY platform (number: INPLASY202450049).
背景
精神疾病可能与中风风险升高有关；然而，不同人群之间这种关联的差异是否存在仍存在争议。因此，我们进行了一项全面的系统评价和荟萃分析，以研究精神疾病与中风风险之间关系的程度。
方法
系统检索了PubMed、Embase和Cochrane图书馆数据库，以识别从数据库建立到2024年4月的符合条件的研究。汇总结果以相对风险（RRs）和95%置信区间（CIs）表示，并采用随机效应模型方法进行合并分析。还使用敏感性分析和亚组分析进行了进一步的探索性分析。
结果
共选择了36项队列研究，涉及25519635人进行分析。我们注意到，抑郁症（RR：1.50；95%CI：1.34 - 1.68；P < 0.001）、精神分裂症（RR：1.74；95%CI：1.36 - 2.24；P < 0.001）和双相情感障碍（RR：1.65；95%CI：1.27 - 2.14；P < 0.001）与中风风险升高有关。进一步的探索性分析发现，抑郁症与中风风险之间的关联根据调整水平而有所不同（RR比值：0.77；95%CI：0.61 - 0.98；P = 0.034），精神分裂症与中风风险之间的关联根据结局定义而有所不同（RR比值：0.68；95%CI：0.52 - 0.90；P = 0.006）。此外，双相情感障碍与中风风险之间的关联根据研究设计而有所不同（RR比值：0.68；95%CI：0.55 - 0.84；P < 0.001）。
结论
精神疾病与中风风险升高之间的显著关联凸显了加强对精神疾病患者的监测和中风预防的重要性。
系统评价注册
我们的研究在INPLASY平台上注册（编号：INPLASY202450049）。
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