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Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta‐analysis
Open accessAbstract
Metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. The primary aim of this systematic review and meta‐analysis was to assess the prevalence of MetS and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder, comparing subjects with different disorders and taking into account demographic variables and psychotropic medication use. The secondary aim was to compare the MetS prevalence in persons with any of the selected disorders versus matched general population controls. The pooled MetS prevalence in people with severe mental illness was 32.6% (95% CI: 30.8%‐34.4%; N = 198; n = 52,678). Relative risk meta‐analyses established that there was no significant difference in MetS prevalence in studies directly comparing schizophrenia versus bipolar disorder, and in those directly comparing bipolar disorder versus major depressive disorder. Only two studies directly compared people with schizophrenia and major depressive disorder, precluding meta‐analytic calculations. Older age and a higher body mass index were significant moderators in the final demographic regression model (z = −3.6, p = 0.0003, r 2 = 0.19). People treated with all individual antipsychotic medications had a significantly (p<0.001) higher MetS risk compared to antipsychotic‐naïve participants. MetS risk was significantly higher with clozapine and olanzapine (except vs. clozapine) than other antipsychotics, and significantly lower with aripiprazole than other antipsychotics (except vs. amisulpride). Compared with matched general population controls, people with severe mental illness had a significantly increased risk for MetS (RR = 1.58; 95% CI: 1.35‐1.86; p<0.001) and all its components, except for hypertension (p = 0.07). These data suggest that the risk for MetS is similarly elevated in the diagnostic subgroups of severe mental illness. Routine screening and multidisciplinary management of medical and behavioral conditions is needed in these patients. Risks of individual antipsychotics should be considered when making treatment choices.
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TL;DR
This systematic review and meta-analysis found that metabolic syndrome (MetS) affects about one third of people with severe mental illness and is elevated versus matched general population controls. Risk was similar across schizophrenia, bipolar disorder, and major depressive disorder, but differed by age, body mass index, and individual antipsychotic medication.
Key findings
- Pooled MetS prevalence in people with severe mental illness was 32.6% (95% CI: 30.8%–34.4%; N=198; n=52,678), and compared with matched general population controls the relative risk was 1.58 (95% CI: 1.35–1.86; p<0.001).
- MetS prevalence did not differ significantly in direct comparisons of schizophrenia versus bipolar disorder (RR=0.92, 95% CI: 0.79–1.06; p=0.24) or bipolar disorder versus major depressive disorder (RR=0.87, 95% CI: 0.48–1.55; p=0.64); only two studies directly compared schizophrenia and major depressive disorder, precluding meta-analysis.
- Older age and higher body mass index were significant moderators in the final demographic regression model (z=23.6, p=0.0003, r²=0.19).
- Among antipsychotics, MetS prevalence was lowest for aripiprazole (19.4%, 95% CI: 8.0%–34.2%) and highest for clozapine (47.2%, 95% CI: 42.0%–52.6%); antipsychotic-naïve participants had 10.2% (95% CI: 6.8%–14.3%). Compared with controls, risk was increased for all MetS components except hypertension, which showed a statistical trend (RR=1.12, 95% CI: 0.99–1.28; p=0.07).
Methods
- Systematic review and meta-analysis conducted according to MOOSE and PRISMA, searching MEDLINE, PsycARTICLES, EMBASE, and CINAHL from database inception to January 1, 2015.
- Included observational studies in adults with DSM-IV/ICD-10 diagnoses of schizophrenia or related psychotic disorders, bipolar disorder, or major depressive disorder, and MetS defined by non-modified ATP-III, ATP-III-A, IDF, or WHO criteria; 198 studies with 52,678 unique persons with severe mental illness were included.
- Pooled prevalence used the DerSimonian-Laird random-effects proportion method; relative risks were calculated for MetS and its components within and across diagnostic subgroups and versus matched general population controls, with meta-regression for moderators.
Limitations
- The paper states considerable methodological heterogeneity across studies; cross-sectional data meant directionality of medication–metabolic associations could not be deduced with certainty; clinical subtypes and concomitant or previous antidepressant/mood stabilizer use were often insufficiently reported or controlled; publication bias and heterogeneity were encountered, though main findings were robust after trim-and-fill adjustment; and inadequate data on ethnicity and lifestyle behaviors precluded meta-analytic assessment of these factors.
- Evident from the text: there were no data in first-episode bipolar disorder or major depressive disorder patients, precluding comparison with multi-episode patients, and only two studies directly compared schizophrenia and major depressive disorder.
- Evident from the text: illness duration was a significant predictor in separate meta-regression but not in the final model, which the authors note may be due to limited data available for illness duration compared with age.
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65 Own result · 13 Not checked yet · 9 Own method · 5 Own interpretation · 2 No basis given · 1 Partly supported · accuracy not yet measured
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“MetS risk was significantly higher with clozapine and olanzapine (except vs. clozapine) than other antipsychotics, and”
- Also stated in: § Medication use · plain
“Those treated with olanzapine had significantly higher MetS prevalence than those treated with amisulpride (p<0.05),aripiprazole (p<0.001),risperidone (p<0.01) and typical antipsychotic medications (p<0.05).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Medication use · plain
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In the paper
“hyperglycaemia (N 5 20; RR 5 1.51, 95% CI: 1.24-1.84,p<0.001;Q 5 94.4,p<0.001)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Risk of metabolic syndrome and its components in persons with various disorders compared with general population controls
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Compared with matched general population controls, people with severe mental illness had a significantly increased risk for MetS (RR 5 1.58; 95% CI: 1.35-1.86;p<0.001) and all its components, except for hypertension (p 5 0.07).”
- Also stated in: § Risk of metabolic syndrome and its components in persons with various disorders compared with general population controls · plain
“In a pooled relative risk metaanalysis, persons with SMIs (n 5 6,610; 29.2%, 95% CI: 25.9%-32.6%;Q 5 230, p<0.001), compared with general population controls (n 5 101,223; 18.1%, 95% CI: 15.8%-20.5%,Q 5 230, p<0.001), had significantly increased risk of MetS (RR 5 1.58, 95% CI: 1.35-1.86,p<0.001;Q 5 62, p 5 0.003).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Risk of metabolic syndrome and its components in persons with various disorders compared with general population controls · plain
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“low HDL cholesterol (N 5 19; RR 5 1.33, 95% CI: 1.15-1.54,p<0.001;Q 5 114.7, p<0.001)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Risk of metabolic syndrome and its components in persons with various disorders compared with general population controls
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“People with severe mental illness had significantly increased risk for abdominal obesity (N 5 18; RR 5 1.43, 95% CI: 1.23-1.66,p<0.001;Q 5 198.8, p<0.001)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Risk of metabolic syndrome and its components in persons with various disorders compared with general population controls
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Relative risk meta-analyses established that there was no significant difference in MetS prevalence in studies directly comparing schizophrenia versus bipolar disorder, and in those directly comparing bipolar disorder versus major depressive disorder.”
- Also stated in: § Diagnostic subgroups · boosted
“Relative risk meta-analyses established that there was no significant difference in MetS in studies directly comparing schizophrenia (39.2%, 95% CI: 30.5%-48.3%;n 5 2,338) versus bipolar disorder (35.5%, 95% CI: 27.0-44.3%;n 5 2,077) (N 5 10, RR 5 0.92, 95% CI: 0.79%-1.06%;v 2 5 1.33, p 5 0.24; Q 5 21.3, p<0.011).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
boosted- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Diagnostic subgroups · boosted
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In the paper
“People treated with all individual antipsychotic medications had a significantly (p<0.001) higher MetS risk compared to antipsychotic-na€ ıve participants.”
- Also stated in: § Medication use · plain
“Patients treated with all individual antipsychotic medications had significantly (p<0.001) higher MetS risk compared to antipsychotic-na€ ıve participants.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Medication use · plain
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In the paper
“hypertriglyceridemia (N 5 19; RR 5 1.49, 95% CI: 1.28-1.73,p<0.001;Q 5 91.2, p< 0.001)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Risk of metabolic syndrome and its components in persons with various disorders compared with general population controls
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Older age and a higher body mass index were significant moderators in the final demographic regression model (z 5 23.6, p 5 0.0003, r 2 5 0.19).”
- Also stated in: § Demographic variables · plain
“Overall, the final model was a significant predictor of the variance in MetS (z 5 23.6, p 5 0.0003; r 2 5 0.19).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Demographic variables · plain
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In the paper
“with a statistical trend for hypertension (N 5 12; RR 5 1.12, 95% CI: 0.99-1.28,p 5 0.07; Q 5 127.1, p<0.001).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Risk of metabolic syndrome and its components in persons with various disorders compared with general population controls
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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“significantly lower with aripiprazole than other antipsychotics (except vs. amisulpride).”
- Also stated in: § Medication use · plain
“Those treated with aripiprazole had significantly lower odds of MetS compared to other antipsychotic medications (except vs. amisulpride).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Those treated with clozapine consistently had significantly (p<0.001) higher MetS prevalence than those treated with any other individual antipsychotic medication.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Medication use
plaincorrelational- Asserted: passes — The authors put it forward as true.
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“Similarly, there were no differences in the study directly comparing bipolar disorder (29.2%, 95% CI: 14.5%-46.2%;n 5 137) versus major depressive disorder (34.0%, 95% CI: 19.4%-50.3%;n 5 176) (N 5 4; RR 5 0.87, 95% CI: 0.48-1.55;v 2 5 0.21, p 5 0.64; Q 5 7.73, p 5 0.0518).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
plain- Asserted: passes — The authors put it forward as true.
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“The pooled MetS prevalence in people with severe mental illness was 32.6% (95% CI: 30.8%-34.4%;N 5 198; n 5 52,678).”
- Also stated in: § Prevalence of metabolic syndrome and its components · hedged
“The estimated weighted mean prevalence of MetS was 32.6% (95% CI: 30.8%-34.4%,Q 5 3696, p<0.001, n5 52,678).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
plainn = 52,678- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Prevalence of metabolic syndrome and its components · hedged
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“The releative risk of MetS versus age-and gender-matched healthy controls was 1.87 in schizophrenia and related psychotic disorders (95% CI: 1.53-2.29;p<0.001,Q 5 18.3, p 5 0.03; N 5 11, n 5 1,413)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
plaincorrelational- Asserted: passes — The authors put it forward as true.
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“The pooled MetS prevalence was 33.4% (95% CI: 30.8%-36.0%,Q 5 1955.0,p<0.001) in people with schizophrenia (N 5 93, n 5 29,596)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
plainn = 29,596- Asserted: passes — The authors put it forward as true.
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In the paper
“In population-based studies, the pooled prevalence of MetS was 38.9% (95% CI: 34.6%-43.4%,Q 5 458.1, p<0.001;N 5 20, n 5 12,770) for schizophrenia”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
plainn = 12,770 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“In studies reporting on hyperglycaemia, the frequency was 18.8% (N 5 56, n 5 17,508; 95% CI: 16.6%-21.2%,Q 5 906.9, p<0.001) when the threshold was 110 mg/dl (ATP-III)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Prevalence of metabolic syndrome and its components
plainn = 17,508 ·- Asserted: passes — The authors put it forward as true.
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“and 22.7% (95% CI: 20.4%-25.1%,Q 5 2.28, p 5 0.31; N 5 3, n 5 1,503) for major depressive disorder.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
plainn = 1,503- Asserted: passes — The authors put it forward as true.
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In the paper
“first episode was also a unique predictor of lower MetS (coefficient 5 20.7517; 95% CI: 21.4877 to 20.0157; z 5 22, p 5 0.04; r 2 5 0.24).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
plaincorrelational- Asserted: passes — The authors put it forward as true.
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“but not by smoking status (p 5 0.49).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Demographic variables
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The prevalence of MetS was lowest in antipsychotic-na€ ıve participants (10.2%, 95% CI: 6.8%-14.3%).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Medication use
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“and higher body mass index (coefficient 5 0.1537; 95% CI: 0.095-0.2123,z 5 5.14, p< 0.0001)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Demographic variables
plaincorrelational- Asserted: passes — The authors put it forward as true.
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“Restricting the analysis to populationbased studies (N 5 29, n 5 18,594), the overall weighted mean prevalence of MetS was 35.9% (95% CI: 31.8%-40.0%,Q 5 934.8, p<0.001).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Prevalence of metabolic syndrome and its components
plainn = 18,594 ·- Asserted: passes — The authors put it forward as true.
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“The MetS prevalence was significantly higher in Australia and New Zealand compared with all other regions (p<0.001).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Demographic variables
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Among those receiving antipsychotics, participants taking aripiprazole had the lowest MetS prevalence (19.4%, 95% CI:8.0%-34.2%;N 5 6)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Medication use
plaincorrelationaln = 6- Asserted: passes — The authors put it forward as true.
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“30.7% (95% CI: 23.7%-38.1%;N 5 20)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Medication use
plainn = 20- Asserted: passes — The authors put it forward as true.
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In the paper
“Separate meta-regression analyses revealed that higher MetS frequencies were moderated by older age (coefficient 5 0.0278; 95% CI: 0.0178-0.0379,z 5 5.5, p<0.0001)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Demographic variables
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“longer illness duration (coefficient 5 0.0339; 95% CI: 0.0115-0.0564,z 5 2.96, p 5 0.003)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Demographic variables
plaincorrelational- Asserted: passes — The authors put it forward as true.
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“Data from five studies demonstrated a trend for lower pooled MetS prevalence in participants receiving monotherapy (30.4%, 95% CI 25.4%-35.5%,Q 5 15.2, p 5 0.004; n 5 1,364) versus polytherapy (35.2%, 95% CI: 23.8%-47.5%,Q 5 18.8, p 5 0.008; n 5 313) (RR 5 0.81; 95% CI: 0.66-1.01;v 2 5 3.41, p 5 0.065; Q 5 5.87, p 5 0.21).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Medication use
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Comparing MetS in first versus multi-episode patients within illness subgroups, first episode psychosis patients (13.7%, 95% CI: 10.4%-16.9%,Q 5 8.659, p 5 0.034; N 5 4, n 5 424) had a significantly lower MetS risk than those with multi-episode schizophrenia (34.2%, 95% CI: 30.8%-36.0%,Q 5 1,955, p<0.001;N 5 105, n 5 29,596) (z 5 28.9, p< 0.001).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Low HDL cholesterol was present in 39.1% (N 5 86, n 5 26,193; 95% CI: 36.4%-41.9%,Q 5 1.9, p<0.001).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Prevalence of metabolic syndrome and its components
plainn = 26,193 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and 37.3% (95% CI: 27.4-47.8%;N 5 11), respectively.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Medication use
plainn = 11- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“while it was 23.0% (N 5 28, n 5 8,205; 95% CI: 17.3%-29.2%,Q 5 1.1, p<0.001) when the threshold was 100 mg/dl (ATP-III-A and IDF).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Prevalence of metabolic syndrome and its components
plainn = 8,205 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Within this, we pooled the prevalence of MetS in first and multiepisode schizophrenia and found that, although mean age predicted MetS prevalence (coefficient 5 0.0296; 95% CI: 0.013 to 0.0463, z 5 3.49, p 5 0.005)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Pooled MetS prevalences per country ranged from 25.4% (95% CI: 18.5%-32.9%)in Brazil to 50.2% (95% CI: 32.9%-67.4%) in Australia.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Demographic variables
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Hypertriglyceridemia was present in 36.2% (N 5 87, n 5 26,577; 95% CI: 33.1%-39.3%,Q 5 2.7, p<0.001).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Prevalence of metabolic syndrome and its components
plainn = 87 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“whilst those taking clozapine had the highest (47.2%, 95% CI: 42.0%-52.6%;N 5 30).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Medication use
plaincorrelationaln = 30- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“1.58 in bipolar disorder (95% CI: 1.24-2.03;p<0.001,Q 5 6.6, p 5 0.25; N 5 6, n 5 1,125)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When all significant predictors were entered in one meta-regression model, body mass index (coefficient 5 0.142, 95% CI: 0.0438-0.2405,z 5 2.83, p 5 0.004)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Demographic variables
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and 63.2% according to IDF (n 5 3,789; 95% CI: 53.6%-72.3%,Q 5 480.9, p< 0.001).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Prevalence of metabolic syndrome and its components
plainn = 3,789 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“36.2% (95% CI: 31.8%-40.9%;N 5 26)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Medication use
plainn = 26- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“whilst illness duration did not (p 5 0.19).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Demographic variables
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Hypertension (ATP-III, ATP-III-A and IDF) was present in 39.3% (N 5 88, n 5 27,441; 95% CI: 36.1%-42.5%,Q 5 2.7, p<0.001).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Prevalence of metabolic syndrome and its components
plainn = 88 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Similar pooled MetS prevalences were observed in patients with bipolar disorder (31.7%, 95% CI: 27.3%-36.3%,Q 5 843.5, p<0.001;N 5 33, n 5 5,827)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
plainn = 5,827 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and 1.57 in major depressive disorder (95% CI: 1.38-1.79,p<0.001,Q 5 19.0, p 5 0.26; N 5 17, n 5 5,267).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and 34.6% (95% CI: 29.3%-40.0%,Q 5 110.2, p<0.001) in those with related psychotic disorders (N 5 13, n 5 2,850).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
plainn = 2,850 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and age (coefficient 5 0.0556, 95% CI: 0.0025-0.1087,z 5 2.05, p 5 0.04) remained significant predictors”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Demographic variables
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Patients treated with amisulpride, typical antipsychotics, risperidone, olanzapine and quetiapine had MetS frequencies of 22.8% (95% CI: 7.6%-43.2%;N 5 5)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Medication use
plainn = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“28.0% (95% CI: 19.8%-37.2%;N 5 15)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Medication use
plainn = 15- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and major depressive disorder (31.3%, 95% CI: 27.3%-35.5%,Q 5 142.7, p<0.001;N 5 19, n 5 5,415).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
plainn = 5,415 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Overall, the proportion of patients with abdominal obesity was 50.3% by the ATP definitions (n 5 20,210; 95% CI: 46.9%-53.7%,Q 5 1.6, p<0.001)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Prevalence of metabolic syndrome and its components
plainn = 20,210 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A relative risk meta-analysis across 64 studies directly comparing MetS frequencies in male (33.5%, 95% CI: 30.0%-36.7%,Q 5 814, p<0.001; n 5 10,798) versus female (33.4%, 95% CI: 31.5%-38.4%,Q 5 615, p<0.001; n 5 8,027) participants with SMI found no gender differences (RR 5 0.94; 95% CI: 0.85-1.02;v 2 5 2.06, p 5 0.15; Q 5 232.0, p<0.011).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Demographic variables
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were insufficient data for bipolar disorder.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were insufficient data to compare the MetS prevalence between antipsychotic-na€ ıve persons and those treated with specific antidepressants or mood stabilizers in similar populations.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Medication use
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“MetS risk was significantly higher with clozapine, followed by olanzapine.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our meta-analysis also highlighted geographical differences in MetS”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“MetS risk was significantly lower with aripiprazole than with each other antipsychotic for which data were available, including pooled typical antipsychotics, with the only exception of amisulpride.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our data suggest that patients receiving all individual antipsychotic medications are at higher MetS risk when compared to those who are antipsychotic-na€ ıve.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These data suggest that the risk for MetS is similarly elevated in the diagnostic subgroups of severe mental illness.”
- Also stated in: § DISCUSSION · plain
“MetS prevalences were consistently elevated for each of the three diagnostic subgroups compared to the general population, and comparative meta-analyses found no significant differences across schizophrenia, bipolar disorder and major depressive disorder.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § DISCUSSION · plain
In the paper
“About 60% of the excess mortality observed in SMI is due to physical comorbidities, predominantly cardiovascular diseases (CVD) (6).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
What the sources say
- Not checked yetcites [6] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The Begg-Mazumdar (Kendall's tau b 5 0.15, p5 0.0015) and Egger test (bias 5 1.46, 95% CI: 0.15-2.77,p50.0292) indicated some publication bias.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Prevalence of metabolic syndrome and its components
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Previous meta-analyses (21)(22)(23)(24) documented that people with SMI have an increased risk for developing MetS compared with the general population.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
What the sources say
- Not checked yetcites (21)(22)(23)(24)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Meta-analytic comparisons of schizophrenia and related psychotic disorders or bipolar disorder with major depressive disorder are currently lacking.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In the same way, meta-analytic data including all major diagnostic SMI subgroups (i.e., schizophrenia and related psychotic disorders versus bipolar disorder versus major depressive disorder) are absent in the literature.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“because our study findings were based on cross-sectional rather than longitudinal data, directionality of the association between medication use and observed metabolic parameters cannot be deduced with certainty”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Third, variables such as clinical subtypes of major depressive and bipolar disorder and concomitant or previous use of antidepressants and mood stabilizers were not reported or were insufficiently reported or controlled for in most available studies.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“First, there was considerable methodological heterogeneity across studies.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Importantly, we also showed for the first time on a large meta-analytic scale that MetS risk differs significantly across commonly used antipsychotic medications.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“which indicates the possible influence of lifestyle and other environmental factors with or without genetic risk differences.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Fifth, there were inadequate data on ethnic distribution and lifestyle behaviors, precluding meta-analytic assessment of these factors as moderating or mediating variables.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 13
- The quote only partly states this claim. 2
- Probably not a substantial claim. 13
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“antipsychotics with lower cardiometabolic risk profiles in short-term studies are often prescribed for higher risk patients in clinical care, which may lead to a not reduced or even increased cardiometabolic risk in naturalistic settings (42).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
What the sources say
- Partly supportedcites [42] sourceExperimental — accuracy not yet measured
In 'Individual antipsychotics and incident diabetes' (p. 4), the authors suggest that patients at higher diabetes risk may have been prescribed ziprasidone or sertindole because of their perceived favourable metabolic profiles, contributing to higher observed diabetes rates. They explicitly say this selection was not systematic, and 'Implications' (p. 6) identifies aripiprazole as a counterexample. The claim's 'often' and its broader reference to cardiometabolic risk overstate findings framed around particular drugs and incident diabetes. (LLM, conf=0.87)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Only two studies directly compared people with schizophrenia and major depressive disorder, precluding meta-analytic calculations.”
- Also stated in: § Diagnostic subgroups · plain
“Only two studies directly compared MetS in people with schizophrenia and major depressive disorder, precluding meta-analytic calculations.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
plainn = 2- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Diagnostic subgroups · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The trim-andfill method demonstrated that adjusting for publication bias had little effect on the pooled MetS estimate, which was virtually identical (32.5%, 95% CI: 30.8%-34.2%,Q 5 2991, p<0.01, n 5 52,678).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Prevalence of metabolic syndrome and its components
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were no data in first-episode bipolar disorder or major depressive disorder patients, precluding a comparison with multi-episode patients.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“South-America | 10 | 25.8% (95% CI: 20.7%-31.3%)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This finding may, however, be somewhat affected by different MetS criteria, with IDF criteria, which are often used in Australian studies, being associated with the highest MetS prevalences.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Australia and New Zealand* | 6 | 50.2% (95% CI: 35.3%-65.0%)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
In the paper
“This mortality gap translates into a 10-20 year shortened life expectancy (3,4) and appears to be widening (5).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
What the sources say
- Not checked yetcites [5] source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“People with severe mental illness (SMI), including schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder (MDD), experience a twothree times higher mortality rate than the general population (1,2).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“This mortality gap translates into a 10-20 year shortened life expectancy (3,4) and appears to be widening (5).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Methodological appraisal was performed according to PRISMA standards (28), including evaluation of bias (confounding, overlapping data, publication bias).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Search criteria, study selection and critical appraisal
What the sources say
- Not checked yetcites [28] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“A brief meta-analytic report comparing MetS frequencies in patients with schizophrenia and bipolar disorder found that these populations are at similar risk (25).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
What the sources say
- Not checked yetcites [25] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In order to increase homogeneity of compared samples and eliminate smaller studies with less precise point estimates, we also conducted sensitivity analyses, restricting the sample to large, population-based studies.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Statistical analyses
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Two independent authors (DV, BS) searched MEDLINE, PsycARTICLES, EMBASE and CINAHL from database inception to January 1, 2015.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Search criteria, study selection and critical appraisal
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“This systematic review was conducted in accordance with the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines (27) and in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard (28).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Inclusion and exclusion criteria
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“In the general population, these clustered risk factors have been associated with the development of CVD and excess mortality (13)(14)(15).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
What the sources say
- Not checked yetcites (13)(14)(15)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Publication bias was tested using the Egger's regression method (29) and Begg-Mazumdar test (30), with a p value <0.05 suggesting the presence of bias.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Search criteria, study selection and critical appraisal
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The trimand-fill approach (32) was used to adjust the overall estimate for funnel plot asymmetry.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Statistical analyses
What the sources say
- Not checked yetcites [32]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Factors predisposing people with SMI to CVD include antipsychotic medication and unhealthy lifestyles (7) as well as their reduced likelihood to receive standard levels of medical care (8)(9)(10)(11)(12).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
What the sources say
- Not checked yetcites [7] source
- Not checked yetcites (8)(9)(10)(11)(12)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“However, these findings should be interpreted with caution, since comparisons were performed at study level and not limited to studies directly comparing the two populations, and patient samples were not matched for age and illness duration (26).”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Abstract
What the sources say
- Not checked yetcites [26] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Fourth, a threat to the validity of any meta-analysis is publication bias and heterogeneity, which we encountered in several of our analyses.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“To our knowledge, this is the first meta-analysis of MetS and its components including and comparing data from the main SMIs: schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“However, although the main findings were heterogeneous, they were also highly robust and not influenced by publica-tion bias, being virtually unaltered after applying the trimand-fill method.”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Since age is a relevant risk factor for MetS in the general population too, the relative MetS risk *Two-sided p<0.05, two-sided p<0.01, ***two-sided p<0.001”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > DISCUSSION
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“chronic conditions such as coronary artery disease, fibromyalgia, rheumatoid arthritis, and mood disorders such as Major Depressive Disorder (MDD) and Post Traumatic Stress Disorder (PTSD) have also been associated with abnormally high CORT levels and metabolic disruptions ( 5-13 ).”
From Dynamic modulation of glucose utilisation by glucocorticoid rhythms in health and disease (2020) · cites this paper as [13]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“many of these conditions are accompanied by a disruption of normal glucose metabolism while preserving some degree of CORT rhythmicity.”
From Dynamic modulation of glucose utilisation by glucocorticoid rhythms in health and disease (2020) · cites this paper as [13]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“People with severe mental illness (schizophrenia, bipolar disorder or major depressive disorder) have higher levels of somatic comorbidities and premature mortality than the general population 1-3 .”
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“in hypercortisolism, it is not only that CORT levels are higher than normal, but in some cases, they also display abnormal rhythmicity. This varies depending on whether the underlying condition is associated with Cushing's syndrome, depression, PTSD, acute inflammation following major surgery, or chronic inflammatory diseases (e.g., rheumatoid arthritis) ( 2, 5-13, 57-60 ).”
From Dynamic modulation of glucose utilisation by glucocorticoid rhythms in health and disease (2020) · cites this paper as [13]
Experimental — accuracy not yet measuredIn the citing paper
“There is evidence for the use of pyridostigmine 96 , non-steroidal anti-inflammatories 97 , caffeine 98 and erythropoietin 99 as adjunctive agents in patients who remain symptomatic with the above regime.”
From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [97]
In the citing paper
“The current meta-analysis adds to the evidence that a first-episode diagnosis is a unique predictor of lower T2DM prevalence independent of mean age, a finding that was also apparent in a recent analysis of metabolic syndrome prevalences across patients with the same three main SMIs 33 .”
From Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: a systematic review and large scale meta‐analysis (2016) · cites this paper as [33]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
“The pooled MetS prevalence was 33.4% (95% CI: 30.8%-36.0%,Q 5 1955.0,p<0.001) in people with schizophrenia (N 5 93, n 5 29,596)”
§ Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis > Diagnostic subgroups
“multi-episode schizophrenia (34.2%, 95% CI: 30.8%-36.0%,Q 5 1,955, p<0.001;N 5 105, n 5 29,596)”
Citations
Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000097 · Cited by 64,042
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552
Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & the PRISMA Group* (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00135 · Cited by 37,554
Toprak, Ö., Kurt, H., Sarı, Y., Şarkış, C., Us, H., & Kırık, A. (2017) · Kidney & Blood Pressure Research · doi:10.1159/000468530 · Cited by 29,772
Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944
Expert Panel on Detection, E. (2001) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.285.19.2486 · Cited by 26,011
Dermyshi, E., Wang, Y., Yan, C., Hong, W., Qiu, G., Gong, X., & Zhang, T. (2017) · Neonatology · doi:10.1159/000454668 · Cited by 24,586
Meta-analysis of Observational Studies in Epidemiology<SUBTITLE>A Proposal for Reporting</SUBTITLE>
Stroup, D. F. (2000) · JAMA · doi:10.1001/jama.283.15.2008 · Cited by 20,623
Research works printed but not linked: 2
- World Health Organization, 1999, Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus
- Duvall S, 2000, A non‐parametric ‘trim and fill’ method for assessing publication bias in meta‐analysis, J Am Stat Assoc, 95, 89
Cited by
Sorted by citations
Correll, C. U., Solmi, M., Veronese, N., Bortolato, B., Rosson, S., Santonastaso, P., Thapa‐Chhetri, N., Fornaro, M., Gallicchio, D., Collantoni, E., et al. (2017) · World Psychiatry · doi:10.1002/wps.20420 · Cited by 1,729
Self-citationFirth, J., Siddiqi, N., Koyanagi, A., Siskind, D., Rosenbaum, S., Galletly, C., Allan, S., Caneo, C., Carney, R., Carvalho, A. F., et al. (2019) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30132-4 · Cited by 1,531
Self-citationPillinger, T., McCutcheon, R. A., Vano, L., Mizuno, Y., Arumuham, A., Hindley, G., Beck, K., Natesan, S., Efthimiou, O., Cipriani, A., et al. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30416-x · Cited by 1,090
McIntyre, R. S., Berk, M., Brietzke, E., Goldstein, B. I., López-Jaramillo, C., Kessing, L. V., Malhi, G. S., Nierenberg, A. A., Rosenblat, J. D., Majeed, A., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)31544-0 · Cited by 1,047
Vancampfort, D., Firth, J., Schuch, F. B., Rosenbaum, S., Mugisha, J., Hallgren, M., Probst, M., Ward, P. B., Gaughran, F., De Hert, M., et al. (2017) · World Psychiatry · doi:10.1002/wps.20458 · Cited by 957
Self-citation
Metadata
- Authors
- Vancampfort, D., Stubbs, B., Mitchell, A. J., De Hert, M., Wampers, M., Ward, P. B., Rosenbaum, S., & Correll, C. U.
- Affiliations
- KU Leuven (BE)
- University of Greenwich (GB)
- University of Leicester (GB)
- UPC KU Leuven, Campus Kortenberg, Department of Neurosciences, KU Leuven ‐ University of Leuven Kortenberg Belgium
- UNSW Sydney (AU)
- Hofstra University (US)
- ORCID
- Venue
- World Psychiatry
- Publisher
- Wiley
- Published
- 2015-09-25
- Volume
- 14
- Issue
- 3
- Pages
- 339-347
- ISSN
- 1723-8617 (ISSN-L)
- 2051-5545
- PMC
- PMC4592657
- OpenAlex
- W2150458484
- Cited by
- 1,271
- References
- 65
- Citations by year
- 2026: 120 · 2025: 142 · 2024: 122 · 2023: 101 · 2022: 117 · 2021: 138 · 2020: 132 · 2019: 101 · 2018: 131 · 2017: 96 · 2016: 65 · 2015: 4
- FWCI
- 13.57
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- World Psychiatry (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (publishedVersion, other-oa)
- Lirias (KU Leuven) (submittedVersion, other-oa)
- Lirias (KU Leuven) (submittedVersion)
- Funders
- Yale University
- University of Pittsburgh
- University of Rochester
- Postgraduate Institute of Medical Education and Research, Chandigarh
- Newcastle University
- Rijksuniversiteit Groningen
- Universiteit Utrecht
- Vrije Universiteit Amsterdam
- University of Toronto
- Kuopion Yliopistollinen Sairaala
- Taipei Medical University
- University of California, San Diego
- Medical Center, University of Rochester
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- metabolic syndrome, schizophrenia, bipolar disorder, major depressive disorder, psychosis, severe mental illness, antipsychotic drugs, clozapine, olanzapine, aripiprazole, body mass index, cardiovascular risk, hypertension, metabolic syndrome prevalence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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