Bidirectional Associations Between Clinically Relevant Depression or Anxiety and COPD A Systematic Review and Meta-analysis
Bidirectional Associations Between Clinically Relevant Depression or Anxiety and COPD A Systematic Review and Meta-analysis
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DOI：
10.1378/chest.12-1911
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发表时间：
2013-09-01
期刊：
影响因子：
9.6
通讯作者：
Smith, Sheree
中科院分区：
文献类型：
--
作者：
Atlantis, Evan;Fahey, Paul;Smith, Sheree
背景资料：抑郁或焦虑与COPD之间的纵向联系，以及它们对预后的共病效应，在以前的综述中没有得到充分的讨论。我们的目的是系统地评估这些协会，为指导方针和practice.Methods：我们搜索电子数据库发表的文章在2012年5月之前。在成人人群中进行的纵向研究报告了临床相关抑郁或焦虑与COPD之间的相关性，或报告了其对急性加重和/或死亡率的共病效应，符合条件。使用随机效应模型汇总研究中的风险比（RR），并使用固定效应模型进行验证。通过亚组和荟萃回归分析探讨异质性。22篇引文产生了16项关于抑郁或焦虑作为COPD结局预测因子的研究在28，759名参与者中进行了1至8年的COPD（事件COPD/慢性肺部疾病或加重）和/或死亡率的研究，并在7，439，159名参与者中进行了6项关于COPD作为抑郁症预测因子的研究，随访时间为1至35年。抑郁或焦虑持续增加COPD结局的风险（RR，1.43; 95%CI，1.22-1.68），特别是在高质量研究和老年人中
Background: The longitudinal associations between depression or anxiety and COPD, and their comorbid effect on prognosis, have not been adequately addressed by previous reviews. We aimed to systematically assess these associations to inform guidelines and practice.Methods: We searched electronic databases for articles published before May 2012. Longitudinal studies in adult populations that reported an association between clinically relevant depression or anxiety and COPD, or that reported their comorbid effect on exacerbation and/or mortality, were eligible. Risk ratios (RRs) were pooled across studies using random-effects models and were verified using fixed-effects models. Heterogeneity was explored with subgroup and metaregression analyses.Results: Twenty-two citations yielded 16 studies on depression or anxiety as predictors of COPD outcomes (incident COPD/chronic lung disease or exacerbation) and/or mortality, in 28,759 participants followed for 1 to 8 years, and six studies on COPD as a predictor of depression in 7,439,159 participants followed for 1 to 35 years. Depression or anxiety consistently increased the risk of COPD outcomes (RR, 1.43; 95% CI, 1.22-1.68), particularly in higher-quality studies and in people aged