Liberati Elisa, Kelly Sarah, Price Annabel, Richards Natalie, Gibson John, Olsson Annabelle, Watkins Stella, Smith Emily, Cole Serena, Kuhn Isla, Martin Graham
The Healthcare Improvement Studies (THIS) Institute, University of Cambridge, Cambridge, UK.
Division of Psychology and Language Sciences, University College London, London, UK.
EClinicalMedicine. 2025 Jan 10;80:103026. doi: 10.1016/j.eclinm.2024.103026. eCollection 2025 Feb.
Inaccurate diagnosis of physical health problems in people with mental health conditions may contribute to poorer health outcomes. We review the evidence on whether individuals with mental health conditions are at risk of diagnostic inequalities related to their physical health.
We searched MEDLINE, PsycINFO, Embase, and CINAHL, 1 September 2002-18 Septemebr 2024 (PROSPERO 2022: CRD42022375892). Seventy-nine studies were eligible for inclusion. Risk of Bias (RoB) was assessed using the Newcastle-Ottawa or RoB2 tools and results were presented as a narrative synthesis.
Findings from the included studies suggests that people with mental health conditions face diagnostic inequalities for their physical health. A minority of studies adopted a design that specifically measured professional- and service-related factors associated with diagnostic inequalities. Most studies, however, measured diagnostic endpoints only, meaning that no inference could be made regarding the relative impact of patients' and clinicians' behaviour in producing inequalities.
Further investigations should consider the stage of the diagnostic process at which inequalities occur, to improve knowledge of the mechanisms underpinning diagnostic inequalities, and support the development of targeted improvement interventions.
This study is funded by The Health Foundation's grant to the University of Cambridge for The Healthcare Improvement Studies (THIS) Institute. Grant number not applicable.
对患有精神疾病的人群的身体健康问题进行不准确的诊断可能会导致更差的健康结果。我们回顾了有关患有精神疾病的个体是否存在与其身体健康相关的诊断不平等风险的证据。
我们检索了MEDLINE、PsycINFO、Embase和CINAHL数据库，检索时间为2002年9月1日至2024年9月18日（PROSPERO 2022：CRD42022375892）。79项研究符合纳入标准。使用纽卡斯尔-渥太华或RoB2工具评估偏倚风险，并以叙述性综述的形式呈现结果。
纳入研究的结果表明，患有精神疾病的人群在身体健康方面面临诊断不平等。少数研究采用了专门测量与诊断不平等相关的专业和服务相关因素的设计。然而，大多数研究仅测量了诊断终点，这意味着无法推断患者和临床医生行为在产生不平等方面的相对影响。
进一步的研究应考虑诊断过程中出现不平等的阶段，以增进对诊断不平等背后机制的了解，并支持制定有针对性的改进干预措施。
本研究由健康基金会向剑桥大学医疗保健改进研究（THIS）研究所提供的赠款资助。赠款编号不适用。
