TY - JOUR
T1 - Increased rates of respiratory disease in schizophrenia
T2 - A systematic review and meta-analysis including 619,214 individuals with schizophrenia and 52,159,551 controls
AU - Suetani, Shuichi
AU - Honarparvar, Faraz
AU - Siskind, Dan
AU - Hindley, Guy
AU - Veronese, Nicola
AU - Vancampfort, Davy
AU - Allen, Lauren
AU - Solmi, Marco
AU - Lally, John
AU - Gaughran, Fiona
AU - Stubbs, Brendon
AU - Pillinger, Toby
N1 - Funding Information:
Brendon Stubbs is supported by a Clinical Lectureship ( ICA-CL-2017-03-001 ) jointly funded by Health Education England (HEE) and the National Institute for Health Research (NIHR). Brendon Stubbs is part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust . Brendon Stubbs also holds active grants with the Medical Research Council (GCRF and multimorbidity calls) and Guys and St Thomas Charity (GSTT) . Toby Pillinger's work is supported by the NIHR and holds an active grant with the Maudsley Charity . GH is supported by the European Union's Horizon 2020 Research and Innovation Action Grant ( 847776 ). FG is in part supported by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, the Stanley Medical Research Institute, the Maudsley Charity and the NIHR Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Funding Information:
We would like to thank Marc Miravitlles from Vall d'Hebron University Hospital and Research Institute for providing additional data. Brendon Stubbs is supported by a Clinical Lectureship (ICA-CL-2017-03-001) jointly funded by Health Education England (HEE) and the National Institute for Health Research (NIHR). Brendon Stubbs is part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust. Brendon Stubbs also holds active grants with the Medical Research Council (GCRF and multimorbidity calls) and Guys and St Thomas Charity (GSTT). Toby Pillinger's work is supported by the NIHR and holds an active grant with the Maudsley Charity. GH is supported by the European Union's Horizon 2020 Research and Innovation Action Grant (847776). FG is in part supported by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, the Stanley Medical Research Institute, the Maudsley Charity and the NIHR Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Publisher Copyright:
© 2021 Elsevier B.V.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/11
Y1 - 2021/11
N2 - Introduction: Despite respiratory disease being a major cause of excess mortality in people with schizophrenia, the prevalence of respiratory conditions in this population is poorly defined. A systematic review and meta-analysis were conducted to establish the prevalence and association of respiratory diseases in people with schizophrenia. Material and methods: Major electronic databases were searched from inception to 27 April 2020 for articles reporting respiratory disease (asthma, chronic obstructive pulmonary disease [COPD], pneumonia, and tuberculosis) in people with schizophrenia and, where possible, a control group. A random-effects meta-analysis was conducted. The study was registered with PROSPERO (CRD42018115137). Results: Of 1569 citations, 21 studies consisting of 619,214 individuals with schizophrenia and 52,159,551 controls were included in the meta-analysis. Compared to the general population, people with schizophrenia had significantly higher rates of COPD (odds ratio [OR]: 1.82, 95% CI: 1.28–2.57), asthma (OR: 1.70, 95% CI: 1.02–2.83), and pneumonia (OR: 2.62, 95% CI: 1.10–6.23). In people with schizophrenia, the prevalence of COPD was 7.7% (95% CI: 4.0–14.4), asthma 7.5% (95% CI: 4.9–11.3), pneumonia 10.3% (95% CI 5.4–18.6), and tuberculosis 0.3% (95% CI 0.1 –0.8). After adjusting for publication bias, the prevalence of COPD increased to 19.9% (95% CI: 9.6–36.7). Discussion: All respiratory diseases examined were significantly more prevalent in people with schizophrenia compared with the general population. Future studies should focus on improving the prevention and management of respiratory disease in this group to reduce associated excess mortality.
AB - Introduction: Despite respiratory disease being a major cause of excess mortality in people with schizophrenia, the prevalence of respiratory conditions in this population is poorly defined. A systematic review and meta-analysis were conducted to establish the prevalence and association of respiratory diseases in people with schizophrenia. Material and methods: Major electronic databases were searched from inception to 27 April 2020 for articles reporting respiratory disease (asthma, chronic obstructive pulmonary disease [COPD], pneumonia, and tuberculosis) in people with schizophrenia and, where possible, a control group. A random-effects meta-analysis was conducted. The study was registered with PROSPERO (CRD42018115137). Results: Of 1569 citations, 21 studies consisting of 619,214 individuals with schizophrenia and 52,159,551 controls were included in the meta-analysis. Compared to the general population, people with schizophrenia had significantly higher rates of COPD (odds ratio [OR]: 1.82, 95% CI: 1.28–2.57), asthma (OR: 1.70, 95% CI: 1.02–2.83), and pneumonia (OR: 2.62, 95% CI: 1.10–6.23). In people with schizophrenia, the prevalence of COPD was 7.7% (95% CI: 4.0–14.4), asthma 7.5% (95% CI: 4.9–11.3), pneumonia 10.3% (95% CI 5.4–18.6), and tuberculosis 0.3% (95% CI 0.1 –0.8). After adjusting for publication bias, the prevalence of COPD increased to 19.9% (95% CI: 9.6–36.7). Discussion: All respiratory diseases examined were significantly more prevalent in people with schizophrenia compared with the general population. Future studies should focus on improving the prevention and management of respiratory disease in this group to reduce associated excess mortality.
KW - Asthma
KW - Chronic obstructive pulmonary disease
KW - Lung disease
KW - Respiratory disease
KW - Schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=85114741879&partnerID=8YFLogxK
U2 - 10.1016/j.schres.2021.08.022
DO - 10.1016/j.schres.2021.08.022
M3 - Review article
AN - SCOPUS:85114741879
SN - 0920-9964
VL - 237
SP - 131
EP - 140
JO - Schizophrenia Research
JF - Schizophrenia Research
ER -
