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dc.contributor.authorSolmi, Marco
dc.contributor.authorFiedorowicz, Jess
dc.contributor.authorPoddighe, Laura
dc.contributor.authorDelogu, Marco
dc.contributor.authorHøye, Anne
dc.contributor.authorMiola, Alessandro
dc.contributor.authorHeiberg, Ina Heidi
dc.contributor.authorStubbs, Brendon
dc.contributor.authorSmith, Lee
dc.contributor.authorLarsson, Henrik
dc.contributor.authorAttar, Rubina
dc.contributor.authorNielsen, René E
dc.contributor.authorCortese, Samuele
dc.contributor.authorShin, Jae Il
dc.contributor.authorFirth, Joseph
dc.contributor.authorFusar-Poli, Paolo
dc.contributor.authorYatham, Lakshmi N
dc.contributor.authorCarvalho, Andre F
dc.contributor.authorCastle, David J
dc.contributor.authorCorrell, Christoph U
dc.contributor.authorSeeman, Mary V
dc.date.accessioned2022-03-31T12:51:39Z
dc.date.available2022-03-31T12:51:39Z
dc.date.issued2021-07-14
dc.description.abstract<p><i>Objective:</i> This study used meta-analysis to assess disparities in cardiovascular disease (CVD) screening and treatment in people with mental disorders, a group that has elevated CVD incidence and mortality. <p><i>Methods:</i> The authors searched PubMed and PsycInfo through July 31, 2020, and conducted a random-effect meta-analysis of observational studies comparing CVD screening and treatment in people with and without mental disorders. The primary outcome was odds ratios for CVD screening and treatment. Sensitivity analyses on screening and treatment separately and on specific procedures, subgroup analyses by country, and by controlling for confounding by indication, as well as meta-regressions, were also run, and publication bias and quality were assessed. <p><i>Results:</i> Forty-seven studies (N=24,400,452 patients, of whom 1,283,602 had mental disorders) from North America (k=26), Europe (k=16), Asia (k=4), and Australia (k=1) were meta-analyzed. Lower rates of screening or treatment in patients with mental disorders emerged for any CVD (k=47, odds ratio=0.773, 95% CI=0.742, 0.804), coronary artery disease (k=34, odds ratio=0.734, 95% CI=0.690, 0.781), cerebrovascular disease (k=8, odds ratio=0.810, 95% CI=0.779, 0.842), and other mixed CVDs (k=11, odds ratio=0.839, 95% CI=0.761, 0.924). Significant disparities emerged for any screening, any intervention, catheterization or revascularization in coronary artery disease, intravenous thrombolysis for stroke, and treatment with any and with specific medications for CVD across all mental disorders (except for CVD medications in mood disorders). Disparities were largest for schizophrenia, and they differed across countries. Median study quality was high (Newcastle-Ottawa Scale score, 8); higher-quality studies found larger disparities, and publication bias did not affect results. <p><i>Conclusions:</i> People with mental disorders, and those with schizophrenia in particular, receive less screening and lower-quality treatment for CVD. It is of paramount importance to address underprescribing of CVD medications and underutilization of diagnostic and therapeutic procedures across all mental disorders.en_US
dc.identifier.citationSolmi, Fiedorowicz, Poddighe, Delogu, Høye, Miola, Heiberg, Stubbs, Smith, Larsson, Attar, Nielsen, Cortese, Shin, Firth, Fusar-Poli, Yatham, Carvalho, Castle, Correll, Seeman. Disparities in Screening and Treatment of Cardiovascular Diseases in Patients With Mental Disorders Across the World: Systematic Review and Meta-Analysis of 47 Observational Studies. American Journal of Psychiatry. 2021en_US
dc.identifier.cristinIDFRIDAID 1979604
dc.identifier.doi10.1176/appi.ajp.2021.21010031
dc.identifier.issn0002-953X
dc.identifier.issn1535-7228
dc.identifier.urihttps://hdl.handle.net/10037/24673
dc.language.isoengen_US
dc.publisherAmerican Psychiatric Publishingen_US
dc.relation.journalAmerican Journal of Psychiatry
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2021 American Psychiatric Publishingen_US
dc.titleDisparities in Screening and Treatment of Cardiovascular Diseases in Patients With Mental Disorders Across the World: Systematic Review and Meta-Analysis of 47 Observational Studiesen_US
dc.type.versionacceptedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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