Daniele Carretta

Metabolic Syndrome in People Suffering from Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis

BACKGROUND Previous reports showed a high prevalence of obesity, diabetes, hypertension, and dyslipidemia among people suffering from posttraumatic stress disorder (PTSD). However, there is a lack of reviews that systematically analyze the relationship between PTSD and metabolic syndrome. We conducted a systematic review and meta-analysis aimed at estimating the association between PTSD and metabolic syndrome. METHODS We systematically searched PubMed, Embase, and Web of Science. We included observational studies assessing the prevalence of metabolic syndrome in a sample with PTSD and in a comparison group without PTSD. Data were analyzed using Review manager 5.1. Odds ratios (OR) with 95% confidence intervals were used as an association measure for pooled analysis, based on a random-effects model. RESULTS Six articles were eligible according to the inclusion criteria, for an overall number of 528 individuals suffering from PTSD and 846 controls without PTSD. The pooled OR for metabolic syndrome for people with PTSD was 1.37 (1.03-1.82). Statistical heterogeneity between the included studies was low (I(2)=22%). CONCLUSIONS Despite some limitations, the findings of this systematic review and meta-analysis confirmed our hypothesis that individuals suffering from PTSD have a greater risk of metabolic syndrome. The potential role of unknown factors or mediators that might clarify the nature of this association needs further research.

Association between depression and non-fatal overdoses among drug users: A systematic review and meta-analysis

BACKGROUND Assessing factors associated with non-fatal overdose is important as these could be useful to identify individuals with substance use disorders at high risk of adverse outcomes and consequences. Depression may play an important role in terms of overdose risk. We aimed to test if drug users suffering from a depressive disorder might have significantly higher risk of non-fatal overdose as compared with drug users without depression. METHODS We conducted a systematic review and meta-analysis. PubMed, Embase and Web of Knowledge were searched. The pooled analyses were based on prevalence rates, risk difference (RD) and odds ratio (OR), reporting 95% confidence intervals (CIs). The combined estimates were obtained weighting each study according to random effects model for meta-analysis. RESULTS Seven articles, involving 12,019 individuals, and run in the US, Canada, Sweden, Norway, and Australia, were included. Pooled analyses comparing depressed with not depressed individuals highlighted a RD (95% CIs) for non-fatal overdose of 7.3% (4.8-9.7%) and an OR (95% CIs) of 1.45 (1.17-1.79). The subgroups analyses based on specific characteristics of included studies confirmed the association between depression and overdose. CONCLUSIONS Depressive disorders seem to be important factors associated to the risk of non-fatal overdose. Longitudinal studies might appropriately clarify causal inference issues. Future research should address the role of depressive disorders as predictors of subsequent non-fatal overdoses.

Cardiovascular risk factors among people with severe mental illness in Italy: A cross-sectional comparative study

OBJECTIVE This study aimed to explore the prevalence of cardiovascular disease (CVD) risk factors in people with severe mental illness (SMI), estimating its weight on related risks in Southern Europe, an area with distinct dietary traditions. People with SMI may be more likely than general population to have high prevalence of risk factors for CVDs, due to several reasons, including poor health behaviours and psychopharmacological medications. METHOD A cross-sectional study has been conducted, comparing inpatients with and without SMI. Univariate and multivariate analyses and logistic regression models have been carried out, exploring the effect of SMI on the prevalence of CVD risk factors. RESULTS Although obesity and hypertriglyceridemia were more prevalent among people with SMI, controlling for relevant confounders in multivariate analyses we could not detect any significant difference. CONCLUSIONS People with SMI may not necessarily have higher CVD risk, as compared with general population. Mediterranean healthy dietary habits, universal health coverage, families providing strong support, all are possible explanations for our findings. Further research is needed, exploring different mechanisms, with more detailed biological and genetics measures.

Prevalence and Correlates of Binge Drinking among Young Adults Using Alcohol: A Cross-Sectional Survey

Background. Although binge drinking prevalence and correlates among young people have been extensively studied in the USA and Northern Europe, less is known for Southern Europe countries with relatively healthier drinking cultures. Objective. We aimed at analyzing prevalence and correlates of binge drinking in a representative sample of young adults in Italy. Methods. We conducted a cross-sectional survey among alcohol-consuming young adults. We carried out univariate and multivariate analyses to assess associations between recent binge drinking and candidate variables. Results. We selected 654 subjects, with 590 (mean age: 20.65 ± 1.90) meeting inclusion criteria. Prevalence for recent binge drinking was 38.0%, significantly higher for females than males. Multivariate analysis showed that high alcohol expectancies, large amount of money available during the weekend, interest for parties and discos, female gender, cannabis use, influence by peers, and electronic cigarettes smoking all were significantly associated with recent binge drinking, whereas living with parents appeared a significant protective factor. Conclusions. More than a third of young adults using alcohol are binge drinkers, and, in contrast with findings from Anglo-Saxon countries, females show higher risk as compared with males. These data suggest the increasing importance of primary and secondary prevention programmes for binge drinking.

Association between depression and neuropathy in people with type 2 diabetes: a meta-analysis

Depression and neuropathy are frequent complications of type 2 diabetes. The current meta‐analysis aimed to estimate the association between depression and neuropathy in subjects with type 2 diabetes.

Risk Estimation Modeling and Feasibility Testing for a Mobile eHealth Intervention for Binge Drinking Among Young People: The D-ARIANNA (Digital-Alcohol RIsk Alertness Notifying Network for Adolescents and young adults) Project

BACKGROUND Binge drinking is common among young people but often relevant risk factors are not recognized. eHealth apps, attractive for young people, may be useful to enhance awareness of this problem. We aimed at developing a current risk estimation model for binge drinking, incorporated into an eHealth app--D-ARIANNA (Digital-Alcohol RIsk Alertness Notifying Network for Adolescents and young adults)--for young people. METHODS A longitudinal approach with phase 1 (risk estimation), phase 2 (design), and phase 3 (feasibility) was followed. Risk/protective factors identified from the literature were used to develop a current risk estimation model for binge drinking. Relevant odds ratios were subsequently pooled through meta-analytic techniques with a random-effects model, deriving weighted estimates to be introduced in a final model. A set of questions, matching identified risk factors, were nested in a questionnaire and assessed for wording, content, and acceptability in focus groups involving 110 adolescents and young adults. RESULTS Ten risk factors (5 modifiable) and 2 protective factors showed significant associations with binge drinking and were included in the model. Their weighted coefficients ranged between -0.71 (school proficiency) and 1.90 (cannabis use). The model, nested in an eHealth app questionnaire, provides in percent an overall current risk score, accompanied by appropriate images. Factors that mostly contribute are shown in summary messages. Minor changes have been realized after focus groups review. Most of the subjects (74%) regarded the eHealth app as helpful to assess binge drinking risk. CONCLUSIONS We could produce an evidence-based eHealth app for young people, evaluating current risk for binge drinking. Its effectiveness will be tested in a large trial.

Web- and text-based interventions for smoking cessation: Meta-analysis and meta-regression

Abstract Background: In the past decade, several smoking cessation interventions have been developed and implemented through information and communication technology (ICT). Evidence suggests that they might be suitable for large-scale public health interventions, based on updated communication media characteristics in terms of interplay between technology and graphical user interface, reaching high numbers of individuals. Objectives: We aimed at estimating web/text-based interventions effectiveness as compared with approaches routinely used for general population, that is smoking assessment or non-electronic self-help materials. Methods: A systematic review and meta-analysis was performed searching through PubMed, Embase and PsycInfo databases, as well as references of relevant papers. Heterogeneity and risk of bias were evaluated following standard methods. In addition, we performed meta-regression analyses testing if candidate covariates moderate the overall effect. Results: Slight but significant effectiveness was found for eHealth interventions over control conditions (RR = 1.28, 95% CI: 1.14–1.45). Meta-regressions showed similar findings for web- and text-based interventions. The effect seemed moderated by the follow-up period, being higher at 3 months and lower at 6/7 months follow-up. Conclusions: Our results outline moderate effectiveness of web/text-based interventions. However, a paucity of properly controlled studies and lack of information on several effect modifiers still hamper the development and implementation of smoking cessation interventions through ICT.

1842 – Severe mental illness and metabolic syndrome: a meta-analysis

Introduction People suffering from Severe Mental Illness (SMI) have a shorter life expectancy than general population. The excess of mortality may be primarily due to premature cardiovascular diseases. Subjects with a diagnosis of SMI may have an high prevalence of Metabolic Syndrome (MetS). Aim To estimate the risk of MetS among subjects with SMI compared to their counterpart without SMI. Methods A systematic review and meta-analysis of English and non-English articles using PubMed, Embase and PsycINFO was performed. ORs with related confidence intervals were used as association measures. All pooled analyses were based on random-effects models. Results The pooled analysis showed a statistically significant association for MetS in people suffering from SMI. However, we found a consistent level of heterogeneity between the included studies. Subanalyses showed that both SCZ and BD had higher risk than general population without SMI. No statistical differences were found comparing SCZ and BD subjects. Conclusions People with SMI have significantly higher risk to having MetS than general population. Despite some limitations, the results of present meta-analysis emphasize the relevance of a continuous cardio-metabolic assessment in the SMI population. Longitudinal researches are needed in order to assess the impact of a regular cardiovascular screening, prevention and treatment on the improvement of health status and life expectancy among people suffering from SMI.