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1.
Modifiable lifestyle and environmental factors associated with onset of psoriatic arthritis in patients with psoriasis: A systematic review and meta-analysis of observational studies.
Xie, W, Huang, H, Deng, X, Gao, D, Zhang, Z
Journal of the American Academy of Dermatology. 2021;(3):701-711
Abstract
BACKGROUND Psoriatic arthritis (PsA) is a progressive joint disease associated with psoriasis. OBJECTIVES To investigate the association of modifiable lifestyle and environmental factors with PsA risk among people with psoriasis. METHODS We conducted a systematic search of PubMed, Embase, and Cochrane Library through May 2, 2020, for observational studies reporting lifestyle or environmental factors for PsA onset in patients with psoriasis. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were combined using a random-effects model. RESULTS We included 16 studies comprising 322,967 individuals. Obesity and being overweight were associated with an increased PsA risk in patients with psoriasis (OR, 1.75 [95% CI, 1.42-2.16] and OR, 1.50 [95% CI, 1.08-2.09], respectively), with an increase of approximately 6% for each kg/m2 rise in body mass index (OR, 1.06; 95% CI, 1.03-1.10). The presence of PsA was associated with a history of physical trauma (OR, 1.33; 95% CI, 1.16-1.54) or fracture (OR, 1.46; 95% CI, 1.22-1.74). No significant associations were observed regarding alcohol consumption (OR, 0.99; 95% CI, 0.88-1.13), smoking (OR, 0.89; 95% CI, 0.75-1.06), female hormonal exposure (OR, 1.45; 95% CI, 0.95-2.20), and psychologically traumatic events. LIMITATIONS Inherent limitations in the included observational studies. CONCLUSIONS Several lifestyle and environmental factors are associated with PsA onset among patients with psoriasis. These findings indicate that such risk may be modified with lifestyle changes or avoidance of physical trauma in people with psoriasis.
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2.
Leptin as a Biomarker of Stress: A Systematic Review and Meta-Analysis.
Bouillon-Minois, JB, Trousselard, M, Thivel, D, Benson, AC, Schmidt, J, Moustafa, F, Bouvier, D, Dutheil, F
Nutrients. 2021;(10)
Abstract
BACKGROUND Leptin is a satiety hormone mainly produced by white adipose tissue. Decreasing levels have been described following acute stress. OBJECTIVE To conduct a systematic review and meta-analysis to determine if leptin can be a biomarker of stress, with levels decreasing following acute stress. METHODS PubMed, Cochrane Library, Embase, and ScienceDirect were searched to obtain all articles studying leptin levels after acute stress on 15 February 2021. We included articles reporting leptin levels before and after acute stress (physical or psychological) and conducted random effects meta-analysis (DerSimonian and Laird approach). We conducted Meta-regressions and sensitivity analyses after exclusion of groups outside the metafunnel. RESULTS We included seven articles-four cohort and three case-control studies-(28 groups) from 27,983 putative articles. Leptin levels decreased after the stress intervention (effect size = -0.34, 95%CI -0.66 to -0.02) compared with baseline levels, with a greater decrease after 60 min compared to mean decrease (-0.45, -0.89 to -0.01) and in normal weight compared to overweight individuals (-0.79, -1.38 to -0.21). There was no difference in the overweight population. Sensitivity analyses demonstrated similar results. Levels of leptin after stress decreased with sex ratio-i.e., number of men/women-(-0.924, 95%CI -1.58 to -0.27) and increased with the baseline levels of leptin (0.039, 0.01 to 0.07). CONCLUSIONS Leptin is a biomarker of stress, with a decrease following acute stress. Normal-weight individuals and women also have a higher variation of leptin levels after stress, suggesting that leptin may have implications in obesity development in response to stress in a sex-dependent manner.
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Fasting Interventions for Stress, Anxiety and Depressive Symptoms: A Systematic Review and Meta-Analysis.
Berthelot, E, Etchecopar-Etchart, D, Thellier, D, Lancon, C, Boyer, L, Fond, G
Nutrients. 2021;(11)
Abstract
BACKGROUND Fasting interventions have shown effectiveness in alleviating stress, anxiety and depressive symptoms. However, no quantitative analysis has been carried out thus far. The objective was to determine the effectiveness of fasting interventions on stress, anxiety and depression and if these interventions were associated with increased or decreased fatigue/energy. METHODS Overall, 11 studies and 1436 participants were included in the quantitative analyses. RESULTS After limiting analyses to randomized controlled trials with low risk of bias, we found that fasting groups had lower anxiety (b = -0.508, p = 0.038), depression levels (b= -0.281, p = 0.012) and body mass index compared to controls without increased fatigue. There was no publication bias and no heterogeneity for these results. These interventions were safe, even in patients with type 2 diabetes. CONCLUSIONS These results should be taken with a caveat. These results are preliminary and encouraging and fasting appears to be a safe intervention. Data are not sufficient to recommend one fasting intervention more than the others. No study was carried out in psychiatric populations and further trials should be carried out in these populations that may be good candidates for fasting interventions.
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The association between chronic psychological stress and uterine fibroids risk: A meta-analysis of observational studies.
Qin, H, Lin, Z, Vásquez, E, Xu, L
Stress and health : journal of the International Society for the Investigation of Stress. 2019;(5):585-594
Abstract
The association between chronic psychological stress and uterine fibroids (UFs) risk remains unclear. In this study, a meta-analysis of observational studies was performed to explore the reported association between them. A literature search was performed in PubMed, EMBASE, and Web of Science to identify relevant published articles. A random-effect model was used to examine pooled odds ratio (OR) and 95% confidence interval (CI). Additionally, subgroup analyses and two-stage random-effect dose-response meta-analysis were performed. A total of six articles with seven studies were included in this meta-analysis. For the highest versus lowest category of chronic psychological stress, the pooled OR was 1.24 (95% CI [1.15, 1.34]; p = .000). Through subgroup analyses, we found a positive association between chronic psychological stress and UFs risk especially in non-Hispanic Blacks studies (OR, 1.24, 95% CI [1.14, 1.34], p = .000). When evaluating for a dose-response, we found a weak correlation between chronic psychological stress and UFs risk, especially for the severe (OR, 1.17, 95% CI [1.07, 1.29]) and very severe (OR, 1.23, 95% CI [1.07, 1.41]) categories. Our meta-analysis shows a statistically significant association between chronic psychological stress and UFs risk particularly for non-Hispanic Blacks. Interventions aiming to reduce chronic psychological stress may be useful to decrease the prevalence of UFs.
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Does growth require suffering? A systematic review and meta-analysis on genuine posttraumatic and postecstatic growth.
Mangelsdorf, J, Eid, M, Luhmann, M
Psychological bulletin. 2019;(3):302-338
Abstract
Previous literature on growth after major life events has primarily focused on negative experiences and operationalized growth with measures which rely on the post hoc self-perception of change. Because this method is prone to many biases, two questions have become increasingly controversial: Is there genuine growth after major life events and does growth require suffering? The present meta-analysis is the first synthesis of longitudinal research on the effects of life events on at least one subdomain of psychological well-being, posttraumatic, or postecstatic growth. Studies needed to have a longitudinal design, assess changes through independent measures over time, and provide sufficient data to estimate change scores. The present meta-analysis comprises 364 effect sizes from 154 independent samples (total N = 98,436) in 122 longitudinal studies. A positive trend has been found for self-esteem, positive relationships, and mastery in prospective studies after both positive and negative events. We found no general evidence for the widespread conviction that negative life events have a stronger effect than positive ones. No genuine growth was found for meaning and spirituality. In the majority of studies with control groups, results did not significantly differ between event and control group, indicating that changes in the outcome variables cannot simply be attributed to the occurrence of the investigated life events. More controlled prospective studies are necessary to validate the genuine nature of postevent growth. Overall, the meta-analysis provides a systematic overview of the state of life event research and delineates important guidelines for future research on genuine growth. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Stressful life events and maltreatment in conversion (functional neurological) disorder: systematic review and meta-analysis of case-control studies.
Ludwig, L, Pasman, JA, Nicholson, T, Aybek, S, David, AS, Tuck, S, Kanaan, RA, Roelofs, K, Carson, A, Stone, J
The lancet. Psychiatry. 2018;(4):307-320
Abstract
BACKGROUND Stressful life events and maltreatment have traditionally been considered crucial in the development of conversion (functional neurological) disorder, but the evidence underpinning this association is not clear. We aimed to assess the association between stressors and functional neurological disorder. METHODS We systematically reviewed controlled studies reporting stressors occurring in childhood or adulthood, such as stressful life events and maltreatment (including sexual, physical abuse, and emotional neglect) and functional neurological disorder. We did a meta-analysis, with assessments of methodology, sources of bias, and sensitivity analyses. FINDINGS 34 case-control studies, with 1405 patients, were eligible. Studies were of moderate-to-low quality. The frequency of childhood and adulthood stressors was increased in cases compared with controls. Odds ratios (OR) were higher for emotional neglect in childhood (49% for cases vs 20% for controls; OR 5·6, 95% CI 2·4-13·1) compared with sexual abuse (24% vs 10%; 3·3, 2·2-4·8) or physical abuse (30% vs 12%; 3·9, 2·2-7·2). An association with stressful life events preceding onset (OR 2·8, 95% CI 1·4-6·0) was stronger in studies with better methods (interviews; 4·3, 1·4-13·2). Heterogeneity was significant between studies (I2 21·1-90·7%). 13 studies that specifically ascertained that the participants had not had either severe life events or any subtype of maltreatment all found a proportion of patients with functional neurological disorder reporting no stressor. INTERPRETATION Stressful life events and maltreatment are substantially more common in people with functional neurological disorder than in healthy controls and patient controls. Emotional neglect had a higher risk than traditionally emphasised sexual and physical abuse, but many cases report no stressors. This outcome supports changes to diagnostic criteria in DSM-5; stressors, although relevant to the cause in many patients, are not a core diagnostic feature. This result has implications for ICD-11. FUNDING None.
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Stressful life events during adolescence and risk for externalizing and internalizing psychopathology: a meta-analysis.
March-Llanes, J, Marqués-Feixa, L, Mezquita, L, Fañanás, L, Moya-Higueras, J
European child & adolescent psychiatry. 2017;(12):1409-1422
Abstract
The main objective of the present research was to analyze the relations between stressful life events and the externalizing and internalizing spectra of psychopathology using meta-analytical procedures. After removing the duplicates, a total of 373 papers were found in a literature search using several bibliographic databases, such as the PsycINFO, Medline, Scopus, and Web of Science. Twenty-seven studies were selected for the meta-analytical analysis after applying different inclusion and exclusion criteria in different phases. The statistical procedure was performed using a random/mixed-effects model based on the correlations found in the studies. Significant positive correlations were found in cross-sectional and longitudinal studies. A transactional effect was then found in the present study. Stressful life events could be a cause, but also a consequence, of psychopathological spectra. The level of controllability of the life events did not affect the results. Special attention should be given to the usage of stressful life events in gene-environment interaction and correlation studies, and also for clinical purposes.
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Early-life adversity and cortisol response to social stress: a meta-analysis.
Bunea, IM, Szentágotai-Tătar, A, Miu, AC
Translational psychiatry. 2017;(12):1274
Abstract
Early-life adversity has been associated with a life-long increased risk for psychopathology and chronic health problems. These long-term negative effects have been explained through stress sensitization, which may involve dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis through either increased or decreased reactivity. The present meta-analysis assessed for the first time the effect of early-life adversity on cortisol response to social stress. Thirty data sets were included in the meta-analysis, in which early-life adversity and salivary cortisol response to social stress were assessed in 4292 individuals of different ages. Results indicated a moderate effect size (g = -0.39) in overall cortisol levels across studies. Separate analyses of cortisol at different stages of response showed large effect sizes at peak and recovery, and a moderate effect at baseline. Heterogeneity was large in this sample of studies and several moderators were identified. The effect size was larger in studies that focused on maltreatment compared to those that included other adversities, and in adults compared to children and adolescents. Percent of women in each sample and methodological quality were positive predictors of the effect size. Publication bias may be present, but the analysis was hampered by the high heterogeneity. Therefore, these results support the association between early-life adversity and blunted cortisol response to social stress, and they suggest that the long-term negative effects of early-life adversity may reach maximum levels in adults.
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Biobehavioral determinants of glycemic control in type 2 diabetes: A systematic review and meta-analysis.
Brown, SA, García, AA, Brown, A, Becker, BJ, Conn, VS, Ramírez, G, Winter, MA, Sumlin, LL, Garcia, TJ, Cuevas, HE
Patient education and counseling. 2016;(10):1558-67
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Abstract
OBJECTIVES To conduct a model-driven meta-analysis of correlational research on psychological and motivational predictors of diabetes outcomes, with adherence factors as mediators. METHODS A comprehensive literature search of published and unpublished studies located a sample of 775 individual correlational or predictive studies reported across 739 research reports. RESULTS Results varied according to the outcome variable included in the regression models. Depression had a larger negative effect on adherence to physical activity than on dietary adherence. Coping and self-efficacy were strongly related to dietary adherence, which was strongly related to improved glycemic control. Medication adherence was related to glycosylated hemoglobin, whereas medications and self-monitoring were related to fasting blood glucose. Adding appointment keeping to the models did not significantly alter the results. CONCLUSION Self-efficacy was the most consistent predictor of all adherence behaviors and dietary adherence was the most significant predictor of HbA1c. Physical activity was the most predictive factor of BMI and glucose self-monitoring the most predictive of FBG. PRACTICE IMPLICATIONS Metabolic control is a primary goal in T2DM, so the best pathway to attaining that goal appears to be an emphasis on self-efficacy and dietary adherence.
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Evidence of perceived psychosocial stress as a risk factor for stroke in adults: a meta-analysis.
Booth, J, Connelly, L, Lawrence, M, Chalmers, C, Joice, S, Becker, C, Dougall, N
BMC neurology. 2015;:233
Abstract
BACKGROUND Several studies suggest that perceived psychosocial stress is associated with increased risk of stroke; however results are inconsistent with regard to definitions and measurement of perceived stress, features of individual study design, study conduct and conclusions drawn and no meta-analysis has yet been published. We performed a systematic review and meta-analysis of studies assessing association between perceived psychosocial stress and risk of stroke in adults.The results of the meta-analysis are presented. METHODS Systematic searches of MEDLINE, EMBASE, CINAHL, PsycInfo, and Cochrane Database of Systematic Reviews were undertaken between 1980 and June 2014. Data extraction and quality appraisal was performed by two independent reviewers. Hazard ratios (HR) and odds ratios (OR) were pooled where appropriate. RESULTS 14 studies were included in the meta-analysis, 10 prospective cohort, 4 case-control design. Overall pooled adjusted effect estimate for risk of total stroke in subjects exposed to general or work stress or to stressful life events was 1.33 (95 % confidence interval [CI], 1.17, 1.50; P < 0.00001). Sub-group analyses showed perceived psychosocial stress to be associated with increased risk of fatal stroke (HR 1.45 95 % CI, 1.19,1.78; P = 0.0002), total ischaemic stroke (HR 1.40 95 % CI, 1.00,1.97; P = 0.05) and total haemorrhagic stroke (HR 1.73 95 % CI, 1.33,2.25; P > 0.0001).A sex difference was noted with higher stroke risk identified for women (HR 1.90 95 % CI, 1.4, 2.56: P < 0.0001) compared to men (HR 1.24 95 % CI, 1.12, 1.36; P < 0.0001). CONCLUSIONS Current evidence indicates that perceived psychosocial stress is independently associated with increased risk of stroke.