All‐cause and cause‐specific mortality in people with depression: a large‐scale systematic review and meta‐analysis of relative risk and aggravating or attenuating factors, including antidepressant treatment
Notice bibliographique
Résumé
Depression has been reported to be associated with premature mortality. However, no meta‐analysis has comprehensively examined all‐cause and cause‐specific mortality risk in people with this condition, focusing also on possible aggravating and attenuating factors, including antidepressant treatment. We conducted a systematic review and meta‐analysis of cohort studies to synthesize mortality risk estimates associated with depression (major depressive disorder and dysthymia) due to any and specific causes, and when depression is accompanied by comorbid conditions. Effects of antidepressant medication and electroconvulsive therapy (ECT), and other potential moderators of mortality risk, were evaluated. We searched EMBASE, Medline and PsycINFO databases up to January 26, 2025, pooling mortality estimates using random‐effect models. Publication bias, subgroup and meta‐regression analyses, and quality assessment (Newcastle‐Ottawa Scale) were performed. Across 268 studies, 10,842,094 individuals with depression and 2,837,933,536 control subjects were included. All‐cause mortality was doubled in people with depression versus no depression/general population controls (relative risk, RR=2.10, 95% CI: 1.87‐2.35, I 2 =99.9%), being especially high for suicide (RR=9.89, 95% CI: 7.59‐12.88, I 2 =99.6%), but also elevated for natural causes (RR=1.63, 95% CI: 1.51‐1.75, I 2 =99.6%). Among individuals with versus without depression matched for comorbid conditions, the depression‐associated mortality risk was also significantly elevated (RR=1.29, 95% CI: 1.21‐1.37, I 2 =99.9%). Depression with versus without psychotic symptoms (RR=1.61, 95% CI: 1.45‐1.78, I 2 =6.3%), and treatment‐resistant versus non‐treatment‐resistant depression (RR=1.27, 95% CI: 1.16‐1.39, I 2 =85.3%), conferred an incremental mortality risk. Antidepressant use (versus no antidepressant use) was associated with significantly lower all‐cause mortality in people with depression (RR=0.79, 95% CI: 0.68‐0.93, I 2 =99.2%). ECT use (versus no ECT use) was associated with reduced all‐cause mortality (RR=0.73, 95% CI: 0.66‐0.82, I 2 =0%), natural‐cause mortality (RR=0.76, 95% CI: 0.59‐0.97, I 2 =12.0%), and suicide (RR=0.67, 95% CI: 0.53‐0.85, I 2 =32.3%). Our results affirm heightened mortality risk in depression, identify clinically relevant patient subgroups with increased mortality risk, and highlight mortality‐reducing effects of antidepressant treatment and ECT. Multipronged intervention approaches targeting physical health improvement and suicide risk alleviation, optimizing antidepressant treatment, and pursuing early identification and effective interventions for psychotic and treatment‐resistant depression, could help reduce this mortality gap, which is still growing.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».