背景:Ehlers-Danlos综合征(EDS)是导致广泛临床表现的结缔组织疾病。当我们开始了解EDS和心理表现之间的联系时,我们必须进一步阐明两者之间的关系。了解EDS与心理健康之间的相关性将更好地确保患者的快速诊断和有效治疗。
目的:本研究旨在系统地研究和报告EDS人群中精神疾病的患病率。
方法:PubMed数据库于2021年6月14日搜索了2011年1月至2021年6月发表的文章。我们包括原创,以证据为基础,同行评审的英文期刊文章,报道了EDS患者中精神疾病的信息。精神疾病和心理状况仅限于国家医学图书馆定义的“心理学”和“精神障碍”医学主题词(MeSH)搜索术语中包含的那些。M.K.利用这种搜索策略确定的出版物被导入到Covidence系统中,他们首先接受了三位独立审稿人的标题和摘要筛选过程(M.K.,K.L.,H.G.).在全文审查期间,两名独立审稿人阅读了有疑问的文章的全文,以评估其纳入资格。如果研究不符合我们的目标目标,或者不是英语,或者是意见,则将其排除在外。会议摘要,或评论文章。数据是从评审员入围的研究中提取的。在数据提取阶段,发表偏倚的质量和风险由两名独立审核员利用美国国立卫生研究院(NIH)研究质量评估工具进行评估.研究选择上的任何分歧,数据提取,或者质量评估是通过两位审稿人之间的讨论来裁决的,如有必要,利用第三审稿人作为决策者。
结果:在确定的73篇文章中,没有重复。共筛选了73条记录,但是只有40篇文章全文被评估为合格。最终共收录23篇,共讨论了12298名参与者。纳入的研究中有10项(43.5%)是横断面设计,3例(13.0%)为病例报告,3例(13.0%)为回顾性图表回顾。其余七篇(30.4%)文章要么是病例对照,队列,定性,受控观测,或验证研究。12项(52.2%)的研究报告了抑郁症的数据,其中6个报告了患病率数据。九项(39.1%)研究报告了焦虑症的数据,其中五个报告了患病率数据。报告非患病率数据的研究显示了比值比,精神病评估的平均分数,和其他相关统计数据。这些文章中报道最多的精神疾病是情绪障碍(n=11),焦虑症(n=9),和神经发育障碍(n=7)。尽管报告各不相同,EDS患者中精神病患病率最高的报告涉及语言障碍(63.2%),注意缺陷/多动障碍(ADHD)(52.4%),焦虑(51.2%),学习障碍(42.4%),抑郁症(30.2%)。
结论:尽管在更多的文章中引用了情绪障碍,报告的患病率最高的是语言障碍和ADHD.这种差异凸显了进行更多研究以更好地了解EDS与精神疾病之间关系的重要性。
BACKGROUND: Ehlers-Danlos syndromes (EDS) are disorders of connective tissue that lead to a wide range of clinical presentations. While we are beginning to understand the association between EDS and psychological manifestations, it is critical that we further elucidate the relationship between the two. Understanding the correlation between EDS and mental health will better ensure swift diagnosis and effective treatment for patients.
OBJECTIVE: This study aims to systematically examine and report the prevalence of psychiatric disorders in the EDS population.
METHODS: The PubMed database was searched on June 14, 2021 for articles published from January 2011 to June 2021. We included original, evidence-based, peer-reviewed journal articles in English that reported information on psychiatric disorders among EDS patients. Psychiatric disorders and psychological conditions were limited to those included in the \"psychology\" and \"mental disorders\" Medical Subject Headings (MeSH) search terms defined by the National Library of Medicine. Publications identified utilizing this search strategy by M.K. were imported into the Covidence system, where they first underwent a title and abstract screening process by three independent reviewers (M.K., K.L., H.G.). During the full-text
review, two independent reviewers read the full text of the questionable articles to assess their eligibility for inclusion. Studies were excluded if they did not meet our target objective or if they were not in English or if they were opinion pieces, conference abstracts, or
review articles. Data were extracted from the shortlisted studies by reviewers. During the data extraction phase, the quality and risk of publication bias were assessed by two independent reviewers utilizing the National Institutes of Health (NIH) Study Quality Assessment Tools. Any disagreements in study selection, data extraction, or quality assessment were adjudicated via discussion between the two reviewers, utilizing a third reviewer as a decider if necessary.
RESULTS: Out of 73 articles identified, there were no duplicates. A total of 73 records were screened, but only 40 articles were assessed in full text for eligibility. A total of 23 articles were ultimately included, which collectively discussed 12,298 participants. Ten (43.5%) of the included studies were cross-sectional in design, three (13.0%) were case reports, and three (13.0%) were retrospective chart reviews. The remaining seven (30.4%) articles were either case-control, cohort, qualitative, controlled observational, or validation studies. Twelve (52.2%) of the studies reported data on depression disorders, six of which reported prevalence data. Nine (39.1%) of the studies reported data on anxiety disorders, five of which reported prevalence data. Studies that reported nonprevalence data presented odds-ratio, mean scores on psychiatric evaluations, and other correlation statistics. Psychiatric disorders that were most reported in these articles were mood disorders (n=11), anxiety disorders (n=9), and neurodevelopmental disorders (n=7). Although the reports varied, the highest psychiatric prevalence reports in EDS patients involved language disorders (63.2%), attention-deficit/hyperactivity disorder (ADHD) (52.4%), anxiety (51.2%), learning disabilities (42.4%), and depression (30.2%).
CONCLUSIONS: Although mood disorders were cited in more articles, the highest reported prevalence was for language disorders and ADHD. This discrepancy highlights the importance of performing more research to better understand the relationship between EDS and psychiatric disorders.