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Meta-Analysis
. 2019 Mar 13;19(1):304.
doi: 10.1186/s12889-019-6623-6.

Co-morbidities of mental disorders and chronic physical diseases in developing and emerging countries: a meta-analysis

Labanté Outcha Daré  1 , Pierre-Emile Bruand  2 , Daniel Gérard  2 , Benoît Marin  3 , Valerie Lameyre  2 , Farid Boumédiène  3 , Pierre-Marie Preux  3
Affiliations
Meta-Analysis

Co-morbidities of mental disorders and chronic physical diseases in developing and emerging countries: a meta-analysis

Labanté Outcha Daré et al. BMC Public Health. .

Abstract

Background: As the data on the association of mental disorders and chronic physical diseases in developing and emerging countries is heterogeneous, this study aims to produce the first meta-analysis of these comorbidities.

Methodology: The meta-analysis protocol was registered in PROSPERO (N°CRD42017056521) and was performed in accordance with PRISMA guidelines. Initially, an article search was conducted on Medline, Embase, Lilacs and the Institut d'Epidémiologie et de Neurologie Tropicale database [Institute of Epidemiology and Tropical Neurology], as well as manually, with no restriction on language or date focusing on mental disorders, chronic diseases and neurotropic diseases. Two independent investigators assessed the quality of the studies which met the inclusion criteria using the Downs and Black assessment grid. The pooled estimates were calculated out using a random-effects method with CMA software Version 3.0. A meta-regression was then performed, and the significance level was set at 0.05.

Results: Of the 2604 articles identified, 40 articles involving 21,747 subjects met the inclusion criteria for co-morbidities between mental disorders and chronic physical diseases. Thirty-one articles were included in the meta-analysis of prevalence studies and 9 articles in that of the analytical studies. The pooled prevalence of mental disorders in patients with chronic physical diseases was 36.6% (95% CI, 31.4-42.1) and the pooled odds ratio was 3.1 (95% CI, 1.7-5.2). There was heterogeneity in all the estimates and in some cases, this was explained by the quality of the studies.

Conclusion: Some estimates regarding the prevalence of mental disorders in people with chronic physical diseases living in developing and emerging countries were similar to those in developed countries. Mental disorders are a burden in these countries. In order to respond effectively and efficiently to the morbidity and mortality associated with them, mental health care could be integrated with physical care.

Keywords: Association; Chronic diseases; Comorbidities; Mental disorders; Meta-analysis.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

VL and PEB are Sanofi employees and own Sanofi stocks. DG is a former employee of Sanofi. All other authors declare that there is no conflict of interest related to the writing and publication of this article.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of research strategy of the meta-analysis of comorbidities of mental disorders and chronic physical diseases in developing and emerging countries
Fig. 2
Fig. 2
Forest plot of the pooled prevalence of anxiety and / or depression in people with chronic physical illnesses (diabetes, obesity, cancers, COPD and heart disease). Heterogeneity: Q = 795.0, df = 28, p < 0.0001, I2 = 96.48. Combined = anxiety & Depression
Fig. 3
Fig. 3
Forest plot of the pooled odds ratio of anxiety and / or depression in people with chronic physical illness (diabetes, obesity, COPD and heart disease).Heterogeneity: Q = 36.81, df = 7, p < 0.0001, I2 = 80.96
Fig. 4
Fig. 4
Funnel plot showing found and missing prevalence studies of comorbidities of mental disorders (anxiety and / or depression) and chronic physical diseases (diabetes, obesity, cancers, COPD and heart disease)
Fig. 5
Fig. 5
Forest plot of pooled odds ratios of comorbidities of mental disorders and chronic physical diseases by type of mental disorder sought. Heterogeneity: Q = 36.76, df = 7.00, p < 0.0001, I2 = 80.96. Combined = anxiety & Depression
See this image and copyright information in PMC

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