scholarly journals The prevalence of personality disorders in the community: a global systematic review and meta-analysis

2019 ◽  
Vol 216 (2) ◽  
pp. 69-78 ◽  
Author(s):  
Catherine Winsper ◽  
Ayten Bilgin ◽  
Andrew Thompson ◽  
Steven Marwaha ◽  
Andrew M. Chanen ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Study Design ◽  
Large Scale ◽  
Meta Analysis ◽  
High Income ◽  
Significant Heterogeneity ◽  
Prevalence Rates ◽  
Middle Income ◽  
Pooled Prevalence

BackgroundPersonality disorders are now internationally recognised as a mental health priority. Nevertheless, there are no systematic reviews examining the global prevalence of personality disorders.AimsTo calculate the worldwide prevalence of personality disorders and examine whether rates vary between high-income countries and low- and middle-income countries (LMICs).MethodWe systematically searched PsycINFO, MEDLINE, EMBASE and PubMed from January 1980 to May 2018 to identify articles reporting personality disorder prevalence rates in community populations (PROSPERO registration number: CRD42017065094).ResultsA total of 46 studies (from 21 different countries spanning 6 continents) satisfied inclusion criteria. The worldwide pooled prevalence of any personality disorder was 7.8% (95% CI 6.1–9.5). Rates were greater in high-income countries (9.6%, 95% CI 7.9–11.3%) compared with LMICs (4.3%, 95% CI 2.6–6.1%). In univariate meta-regressions, significant heterogeneity was partly attributable to study design (two-stage v. one-stage assessment), county income (high-income countries v. LMICs) and interview administration (clinician v. trained graduate). In multiple meta-regression analysis, study design remained a significant predictor of heterogeneity. Global rates of cluster A, B and C personality disorders were 3.8% (95% CI 3.2, 4.4%), 2.8% (1.6, 3.7%) and 5.0% (4.2, 5.9%).ConclusionsPersonality disorders are prevalent globally. Nevertheless, pooled prevalence rates should be interpreted with caution due to high levels of heterogeneity. More large-scale studies with standardised methodologies are now needed to increase our understanding of population needs and regional variations.

scholarly journals Prevalence of personality disorders in the general adult population in Western countries: systematic review and meta-analysis

2018 ◽  
Vol 213 (6) ◽  
pp. 709-715 ◽  
Author(s):  
Jana Volkert ◽  
Thorsten-Christian Gablonski ◽  
Sven Rabung
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Meta Analysis ◽  
Adult Population ◽  
Epidemiological Studies ◽  
Sensitivity Analyses ◽  
Prevalence Rates ◽  
Efficient Treatment ◽  
Random Effects Models ◽  
Western Countries

BackgroundPersonality disorder is a severe health issue. However, the epidemiology of personality disorders is insufficiently described and surveys report very heterogeneous rates.AimsWe aimed to conduct a meta-analysis on the prevalence of personality disorders in adult populations and examine potential moderators that affect heterogeneity.MethodWe searched PsycINFO, PSYNDEX and Medline for studies that used standardised diagnostics (DSM-IV/-5, ICD-10) to report prevalence rates of personality disorders in community populations in Western countries. Prevalence rates were extracted and aggregated by random-effects models. Meta-regression and sensitivity analyses were performed and publication bias was assessed.ResultsThe final sample comprised ten studies, with a total of 113 998 individuals. Prevalence rates were fairly high for any personality disorder (12.16%; 95% CI, 8.01–17.02%) and similarly high for DSM Clusters A, B and C, between 5.53 (95% CI, 3.20–8.43%) and 7.23% (95% CI, 2.37–14.42%). Prevalence was highest for obsessive–compulsive personality disorder (4.32%; 95% CI, 2.16–7.16%) and lowest for dependent personality disorder (0.78%; 95% CI, 0.37–1.32%). A low prevalence was significantly associated with expert-rated assessment (versus self-rated) and reporting of descriptive statistics for antisocial personality disorder.ConclusionsEpidemiological studies on personality disorders in community samples are rare, whereas prevalence rates are fairly high and vary substantially depending on samples and methods. Future studies investigating the epidemiology of personality disorders based on the DSM-5 and ICD-11 and models of personality functioning and traits are needed, and efficient treatment should be a priority for healthcare systems to reduce disease burden.Declaration of interestNone.

scholarly journals BIRTH PREPAREDNESS AND COMPLICATION READINESS OF WOMEN IN NIGERIA: A SYSTEMATIC REVIEW AND META-ANALYSIS

2021 ◽  
Author(s):  
Margaret Omowaleola Akinwaare ◽  
Oyeninhun Abimbola Oluwatosin ◽  
Olalekan A Uthman ◽  
Elizabeth Ike
Keyword(s):  
Systematic Review ◽  
Maternal Death ◽  
Meta Analysis ◽  
Significant Heterogeneity ◽  
Birth Preparedness ◽  
Complication Readiness ◽  
Middle Income ◽  
The Sustainable Development ◽  
Danger Signs ◽  
Pooled Prevalence

Introduction Globally, efforts are being made to reduce the menace of maternal death in order to achieve the sustainable development goal. Maternal death has been associated with inadequate birth preparedness and complication readiness especially in the low and middle income countries. Therefore, this review assessed birth preparedness and complication readiness in Nigeria. Methods A systematic review and meta-analysis of published research articles on birth preparedness and complication readiness in Nigeria was done using PubMed, EMBASE and MEDLINE databases. All published articles from inception to November, 2018 were included in the review. A total of 8913 published articles were identified from electronic search, a total of 4440 studies were included in this review, while only 12 articles met the inclusion criteria and were included in the meta-analysis. Results The pooled prevalence of Good BPCR for all studies yielded an estimate of 58.7% (95% CI 43.9 to 72.7%). The I2 statistic was 98%, indicating statistically significant heterogeneity among the studies. The percentage of women with good birth preparedness and complication readiness increases with increasing year of publication, such that women tended to be more aware good birth preparedness and complication readiness in recent years. More than half of the women had knowledge of obstetric danger signs (52.0%, 95% CI 39.5 to 64.4%, 10 studies), arranged for transportation (59.5%, 95% CI 36.2 to 80.7, 11 studies) or saved money (63.4%, 95% CI 44.7 to 80.2%, 11 studies) as part of the BPCR. Conclusion Women in Nigeria are better prepared for birth preparedness and complication readiness in recent years. Therefore, interventions to promote more adequate birth preparedness and complication readiness among women is recommended.

scholarly journals Prevalence of common mental disorders in adult Syrian refugees resettled in high income Western countries: a systematic review and meta-analysis

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Thomas P. Nguyen ◽  
Maria Gabriela Uribe Guajardo ◽  
Berhe W. Sahle ◽  
Andre M. N. Renzaho ◽  
Shameran Slewa-Younan
Keyword(s):  
Systematic Review ◽  
Mental Illness ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Meta Analysis ◽  
High Income ◽  
Syrian Refugees ◽  
Prevalence Rates ◽  
Western Countries ◽  
Pooled Prevalence

Abstract Background The immense social upheaval and ongoing humanitarian crisis created by the 2011 war in Syria has forced millions of civilians to flee their homeland, many of whom seek refugee status in Western nations. Whilst it is known that the prevalence of mental illness is higher within refugee populations, this systematic review and meta-analysis aims to pool the prevalence rates of common mental disorders (namely posttraumatic stress disorder, depression and generalized anxiety disorder) in adult Syrian refugees resettled in high income Western countries. Methods Seven electronic databases (Medline, PsychInfo, CINAHL, PTSDpubs, SCOPUS, PubMed and Embase) were searched up to the 31st of December 2020. Using pre-determined inclusion and exclusion criteria, relevant articles were screened by title and abstract, and later by full text. A meta-analysis was used to estimate the prevalence rates for each mental illness. Results Eleven studies met the eligibility criteria for the systematic review. Nine of these studies had a low-moderate risk of bias and were included in the meta-analysis. Of the 4873 refugees included in the meta-analysis, the total pooled prevalence rate of having any of the three mental disorders was 33% (CI 95%, 27-40%), 40% for anxiety (CI 95%, 31-50%), 31% for depression (CI 95%, 20-44%) and 31% for PTSD (CI 95%, 22-41%). A meta-regression revealed that the total pooled prevalence rate for having any of the three mental disorders was not influenced by age, host country, duration in host country, educational or marital status. Conclusions Despite significant study heterogeneity, the prevalence rates of common mental disorders in adult Syrian refugees resettled in high-income Western countries are significantly higher than reported rates in the general population.

Global variation in the prevalence and incidence of major depressive disorder: a systematic review of the epidemiological literature

2012 ◽  
Vol 43 (3) ◽  
pp. 471-481 ◽  
Author(s):  
A. J. Ferrari ◽  
A. J. Somerville ◽  
A. J. Baxter ◽  
R. Norman ◽  
S. B. Patten ◽  
...  
Keyword(s):  
Systematic Review ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Meta Analysis ◽  
Significant Heterogeneity ◽  
Major Depressive ◽  
Middle Income ◽  
Pooled Prevalence ◽  
Low Middle Income Countries ◽  
Incidence Studies

BackgroundSummarizing the epidemiology of major depressive disorder (MDD) at a global level is complicated by significant heterogeneity in the data. The aim of this study is to present a global summary of the prevalence and incidence of MDD, accounting for sources of bias, and dealing with heterogeneity. Findings are informing MDD burden quantification in the Global Burden of Disease (GBD) 2010 Study.MethodA systematic review of prevalence and incidence of MDD was undertaken. Electronic databases Medline, PsycINFO and EMBASE were searched. Community-representative studies adhering to suitable diagnostic nomenclature were included. A meta-regression was conducted to explore sources of heterogeneity in prevalence and guide the stratification of data in a meta-analysis.ResultsThe literature search identified 116 prevalence and four incidence studies. Prevalence period, sex, year of study, depression subtype, survey instrument, age and region were significant determinants of prevalence, explaining 57.7% of the variability between studies. The global point prevalence of MDD, adjusting for methodological differences, was 4.7% (4.4–5.0%). The pooled annual incidence was 3.0% (2.4–3.8%), clearly at odds with the pooled prevalence estimates and the previously reported average duration of 30 weeks for an episode of MDD.ConclusionsOur findings provide a comprehensive and up-to-date profile of the prevalence of MDD globally. Region and study methodology influenced the prevalence of MDD. This needs to be considered in the GBD 2010 study and in investigations into the ecological determinants of MDD. Good-quality estimates from low-/middle-income countries were sparse. More accurate data on incidence are also required.

scholarly journals The high risk of malarial recurrence in patients with Plasmodium-mixed infection after treatment with antimalarial drugs: a systematic review and meta-analysis

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Aongart Mahittikorn ◽  
Frederick Ramirez Masangkay ◽  
Kwuntida Uthaisar Kotepui ◽  
Giovanni De Jesus Milanez ◽  
Manas Kotepui
Keyword(s):  
Systematic Review ◽  
Mixed Infection ◽  
Subgroup Analysis ◽  
Initial Treatment ◽  
Meta Analysis ◽  
Antimalarial Drugs ◽  
Secondary Outcome ◽  
Significant Heterogeneity ◽  
Pooled Prevalence ◽  
Significant Difference

Abstract Background Malaria mixed infections are often unrecognized by microscopists in the hospitals, and a delay or failure to treat Plasmodium-mixed infection may lead to aggravated morbidity and increased mortality. The present study aimed to quantify the pooled proportion and risk of malarial recurrences after the treatment of Plasmodium-mixed infection. The results of the study may provide benefits in the management of Plasmodium-mixed infection in co-endemic regions. Methods This systematic review and meta-analysis searched the international Prospective Register of Systematic Reviews (PROSPERO; ID = CRD42020199709), MEDLINE, Web of Science, and Scopus for potentially relevant studies in any language published between January 1, 1936, and July 20, 2020, assessing drug efficacy in patients with Plasmodium-mixed infection. The primary outcome was the pooled prevalence of Plasmodium parasitemia after initiating antimalarial treatment for Plasmodium-mixed infection. The secondary outcome was the pooled risk ratio (RR) of malarial recurrence in Plasmodium-mixed infection compared with those in Plasmodium falciparum and Plasmodium vivax mono-infection. The pooled analyses were calculated by random-effects meta-analysis. After the initial treatment in different days of recurrences (≤ 28 days or > 28 days), the risk of Plasmodium parasitemia was compared in subgroup analysis. Results Out of 5217 screened studies, 11 were included in the meta-analysis, including 4390 patients from six countries. The pooled prevalence of all recurrences of Plasmodium-mixed parasitemia was 30% (95% confidence interval (CI) 16–43; I2: 99.2%; 11 studies). The RR of malarial recurrence within 28 days after the initial treatment (clinical treatment failure) of Plasmodium-mixed parasitemia compared with the treatment of P. falciparum was 1.22 (p: 0.029; 95% CI 1.02–1.47; Cochran Q: 0.93; I2: 0%; six studies), while there was no significant difference in the risk of recurrence 28 days after initial treatment compared with the treatment of P. falciparum (p: 0.696, RR: 1.14; 95% CI 0.59–2.18; Cochran Q < 0.05; I2: 98.2%; four studies). The subgroup analysis of antimalarial drugs showed that significant malarial recurrence within 28 days was observed in patients treated with artemisinin-based combination therapies (ACTs) with no significant heterogeneity (p: 0.028, RR: 1.31; 95% CI 1.03–1.66; Cochran Q: 0.834; I2: 0%). Conclusions The present findings showed a high prevalence of malarial recurrence after the initial treatment of Plasmodium-mixed infection. Moreover, significant malaria recurrence of mixed infection occurred within 28 days after treatment with ACTs. Graphic Abstract

3 Estimating the Burden of Dementia in Latin America and the Caribbean: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i1-i6
Author(s):  
Y Xiang ◽  
K Chan ◽  
I Rudan
Keyword(s):  
Latin America ◽  
Disease Burden ◽  
Meta Analysis ◽  
Public Health Issue ◽  
Middle Income ◽  
Dementia Prevalence ◽  
Pooled Prevalence ◽  
The Future ◽  
The Caribbean ◽  
Policy And Planning

Abstract Background and Objectives Rapid increase in life expectancy has resulted in an increase in the global burden of dementia that is expected to become a leading cause of morbidity in the future. Low- and middle-income countries are expected to bear an increasing majority of the burden, but lack data for accurate burden estimates that are key for informing policy and planning. Bayesian methods have recently gained recognition over traditional frequentist approaches for modelling disease burden for their superiority in dealing with severely limited data. This study provides updated estimates of dementia prevalence in Latin America and the Caribbean (LAC) for the years 2015, 2020 and 2030. Given the paucity of data, estimates were developed using a Bayesian methodology and confirmed by the traditional frequentist approach, with the aim of providing methodological insights for future disease burden estimates. Methods A comprehensive systematic literature search was conducted to identify all relevant primary studies published between the years 2010–2018. The quality of the included studies was critically assessed. A random-effects model (REM) and a Bayesian normal-normal hierarchical model (NNHM) were used to obtain the pooled prevalence estimate of dementia for people aged 60 and above. The latter model was also developed to estimate age-specific dementia prevalence. Using UN population estimates, total and age-specific projections of the burden of dementia were calculated. Results The prevalence of dementia in LAC was found to be 14% (10–21%) in those above age 60 based on REM, and 8% (5–11.5%) based on NNHM. The prevalence increased from 2% (1–4%) in people aged 60–69 to 29% (20–37%) in people above the age of 80. The number of people living with dementia in LAC in 2015 was estimated at 5.68 million, with future projections of 6.86 million in 2020 and 9.94 million in 2030. Conclusions The findings of this review found that burden of dementia in LAC is substantial and continues to rapidly grow. The projected rise in dementia cases in the future should prompt urgent governmental response to address this growing public health issue. We were also able to demonstrate that given the overall paucity of data, a Bayesian approach was superior for estimating disease prevalence and burden.

scholarly journals Assessing the Equity and Redistributive Effects of Taxation Reforms in Nigeria

2021 ◽  
Author(s):  
Henry C. Edeh
Keyword(s):  
Low Income ◽  
Large Scale ◽  
Value Added ◽  
High Income ◽  
Living Standard ◽  
Middle Income ◽  
Variable Part ◽  
Lump Sum ◽  
Redistributive Effects ◽  
Income Taxpayers

Achieving the Sustainable Development Goals (SDGs) of poverty and inequality reduction through redistribution have indeed become critical concerns in many low- and middle-income countries, including Nigeria. Although redistribution results from the effect of tax revenue collections, micro household-level empirical analyses of the distributional effect of personal income tax (PIT) and value added tax (VAT) reforms in Nigeria have been scarcely carried out. This study for the first time quantitatively assessed both the equity and redistributive effects of PIT and VAT across different reform scenarios in Nigeria. Data used in this study was mainly drawn from the most recent large scale nationally representative Nigeria Living Standard Survey, conducted in 2018/2019. The Kakwani Index was used to calculate and compare the progressivity of PIT and VAT reforms. A simple static micro-simulation model was employed in assessing the redistributive effect of PIT and VAT reforms in the country. After informality has been accounted for, the PIT was found to be progressive in the pre- 2011 tax scheme, but turned regressive in the post-2011 tax scheme. It was also discovered that the newly introduced lump sum relief allowance in the post-2011 PIT scheme accrues more to the high-income than to the low-income taxpayers – confirming the regressivity of the current PIT scheme. However, the study further shows (through counterfactual simulations) that excluding the relatively high-income taxpayers from sharing in the variable part of the lump sum relief allowance makes PIT progressive in the post-2011 scheme. The VAT was uncovered to be regressive both in the pre-2020 scheme, and in the current VAT reform scheme. Further, after putting informality into consideration, the PIT was found to marginally reduce inequality but increase poverty in the pre-2011 scheme. The post-2011 PIT scheme reduced inequality and increased poverty, but by a smaller proportion – confirming a limited redistribution mainly resulting from the concentration of the lump sum relief allowance at the top of the distribution. However, if the variable part of the lump sum relief allowance is provided for ‘only’ the low-income taxpayers below a predefined income threshold, the post-2011 PIT scheme becomes largely redistributive. VAT was uncovered to marginally increase inequality and poverty in the pre-2020 scheme. Though the current VAT scheme slightly increased inequality, it considerably increased poverty in the country. It is therefore suggested that a better tax reform, with well-regulated relief allowance and differentiated VAT rates, will help to enhance the equity and redistribution capacity of the Nigeria tax system.

scholarly journals A Systematic Review and Meta-Analysis on Mental Illness Symptoms in Spain in the COVID-19 Crisis

2021 ◽  
Author(s):  
Richard Z. Chen ◽  
Stephen X. Zhang ◽  
Wen Xu ◽  
Allen Yin ◽  
Rebecca Kechen Dong ◽  
...  
Keyword(s):  
Mental Illness ◽  
General Population ◽  
Adult Students ◽  
Meta Analysis ◽  
Total Sample ◽  
Future Research ◽  
Depression Symptoms ◽  
Prevalence Rates ◽  
Pooled Prevalence ◽  
Insomnia Symptoms

AbstractObjectiveThis paper systematically reviews and assesses the prevalence of anxiety, depression, and insomnia symptoms in the general population, frontline healthcare workers (HCWs), and adult students in Spain during the COVID-19 crisis.Data sourcesArticles in PubMed, Embase, Web of Science, PsycINFO, and medRxiv from March 2020 to February 6, 2021.ResultsThe pooled prevalence of anxiety symptoms in 23 studies comprising a total sample of 85,560 was 20% (95% CI: 15% - 25%, I2 = 99.9%), that of depression symptoms in 23 articles with a total sample comprising of 86,469 individuals was 23% (95% CI: 18% - 28%, I2 = 99.8%), and that of insomnia symptoms in 4 articles with a total sample of 915 were 52% (95% CI: 42-64%, I2 = 88.9%). The overall prevalence of mental illness symptoms in frontline HCWs, general population, and students in Spain are 42%, 19%, and 50%, respectively.DiscussionThe accumulative evidence from the meta-analysis reveals that adults in Spain suffered higher prevalence rates of mental illness symptoms during the COVID-19 crisis with a significantly higher rate relative to other countries such as China. Our synthesis reveals high heterogeneity, varying prevalence rates and a relative lack of studies in frontline and general HCWs in Spain, calling future research and interventions to pay attention to those gaps to help inform evidence-based mental health policymaking and practice in Spain during the continuing COVID-19 crisis. The high prevalence rates call for preventative and prioritization measures of the mental illness symptoms during the Covid-19 pandemic.

scholarly journals Pregnancy-related complications and incidence of atrial fibrillation: a systematic review and meta-analysis

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
T Al Bahhawi ◽  
A Aqeeli ◽  
S L Harrison ◽  
D A Lane ◽  
I Buchan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Cohort Studies ◽  
Observational Studies ◽  
Large Scale ◽  
Data Extraction ◽  
Meta Analysis ◽  
Significant Heterogeneity ◽  
Random Effects Models ◽  
Increased Risk

Abstract Funding Acknowledgements Type of funding sources: None. Background Pregnancy-related complications have been previously associated with incident cardiovascular disease. However, data are scarce on the association between pregnancy-related complications and incident atrial fibrillation (AF). This systematic review examines associations between pregnancy-related complications and incident AF. Methods A systematic search of the literature utilising MEDLINE and EMBASE (Ovid) was conducted from 1990 to 6 April 2020. Observational studies examining the association between pregnancy-related complications including hypertensive disorders of pregnancy (HDP), gestational diabetes, placental abruption, preterm birth, low birth weight, small-for-gestational-age and stillbirth, and incidence of AF were included. Screening and data extraction were conducted independently by two reviewers. Inverse-variance random-effects models were used to pool hazard ratios. Results: Six observational studies met the inclusion criteria one case-control study and five retrospective cohort studies, with four studies eligible for meta-analysis.  Sample sizes ranged from 1,839-1,303,365. Mean/median follow-up for the cohort studies ranged from 7-36 years. Most studies reported an increased risk of incident AF associated with pregnancy-related complications. The pooled summary statistic from four studies reflected a greater risk of incident AF for HDP (hazard ratio (HR) 1.47, 95% confidence intervals (CI) 1.18-1.84; I2 = 84%) and from three studies for pre-eclampsia (HR 1.71, 95% CI 1.41-2.06; I2 = 64%; Figure). Conclusions The results of this review suggest that pregnancy-related complications particularly pre-eclampsia appear to be associated with higher risk of incident AF. The small number of included studies and the significant heterogeneity in the pooled results suggest further large-scale prospective studies are required to confirm the association between pregnancy-related complications and AF. Abstract Figure.

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