Risk and protective factors for mental disorders with onset in childhood/adolescence: An umbrella review of published meta-analyses of observational longitudinal studies

Solmi, Marco; Dragioti, Elena; Arango, Celso; Raduà, Joaquim; Ostinelli, Edoardo G; Kılıç, Özge; Yilmaz, Uğur; Yalçınay-İnan, Merve; Soares, Fernanda Cunha; Mariano, Luca; Mosillo, Pierluca; Cortese, Samuele; Correll, Christoph U.; Carvalho, André F.; Smıth, Lee; Fusar‐Poli, Paolo

doi:10.1016/j.neubiorev.2020.09.002

Cited by 19 publications

(14 citation statements)

References 46 publications

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“…Overall, 1,361 records were retrieved, 800 suitable papers were screened, and 14 umbrella reviews were eligible 6,15,27,[32][33][34][35][36][37][38][39][40][41][42] (see Figure 1). The eligible umbrella reviews were published between 2017 and 2021, and reviewed individual studies published from 1995 to 2020.…”

Section: Databasementioning

confidence: 99%

Risk and protective factors for mental disorders beyond genetics: an evidence‐based atlas

et al. 2021

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Decades of research have revealed numerous risk factors for mental disorders beyond genetics, but their consistency and magnitude remain uncer tain. We conducted a "metaumbrella" systematic synthesis of umbrella reviews, which are systematic reviews of metaanalyses of individual studies, by searching international databases from inception to January 1, 2021. We included umbrella reviews on nonpurely genetic risk or protective factors for any ICD/DSM mental disorders, applying an established classification of the credibility of the evidence: class I (convinc ing), class II (highly suggestive), class III (suggestive), class IV (weak). Sensitivity analyses were conducted on prospective studies to test for temporality (reverse causation), TRANSD criteria were applied to test transdiagnosticity of factors, and A Measurement Tool to Assess Systematic Reviews (AMSTAR) was employed to address the quality of metaanalyses. Fourteen eligible umbrella reviews were retrieved, summarizing 390 metaanalyses and 1,180 associations between putative risk or protective factors and mental disorders. We included 176 class I to III evidence associations, relating to 142 risk/protective factors. The most robust risk factors (class I or II, from prospective designs) were 21. For dementia, they included type 2 diabetes mellitus (risk ratio, RR from 1.54 to 2.28), depression (RR from 1.65 to 1.99) and low frequency of social con tacts (RR=1.57). For opioid use disorders, the most robust risk factor was tobacco smoking (odds ratio, OR=3.07). For nonorganic psychotic disorders, the most robust risk factors were clinical high risk state for psychosis (OR=9.32), cannabis use (OR=3.90), and childhood adversities (OR=2.80). For depressive disorders, they were widowhood (RR=5.59), sexual dysfunction (OR=2.71), three (OR=1.99) or fourfive (OR=2.06) metabolic factors, childhood physical (OR=1.98) and sexual (OR=2.42) abuse, job strain (OR=1.77), obesity (OR=1.35), and sleep disturbances (RR=1.92). For autism spectrum disorder, the most robust risk factor was maternal overweight pre/during pregnancy (RR=1.28). For attention deficit/hyperactivity disorder (ADHD), they were maternal prepregnancy obesity (OR=1.63), maternal smoking during pregnancy (OR=1.60), and maternal overweight pre/during pregnancy (OR=1.28). Only one robust protective factor was detected: high physical activity (hazard ratio, HR=0.62) for Alzheimer's disease. In all, 32.9% of the associations were of high quality, 48.9% of medium quality, and 18.2% of low quality. Transdiagnostic class IIII risk/protective factors were mostly involved in the early neurodevelopmental period. The evidencebased atlas of key risk and protective factors identified in this study represents a benchmark for advancing clinical characterization and research, and for expand ing early intervention and preventive strategies for mental disorders.

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Section: Databasementioning

confidence: 99%

Risk and protective factors for mental disorders beyond genetics: an evidence‐based atlas

et al. 2021

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“…This overview is one of the very few works that have assessed the overlap of primary studies in the included SR and MAs. In 2021, Solmi et al stated that the overviews of SRs have an overlap that may result in the exaggeration of the qualitative conclusions and outcomes of meta‐synthesis, if performed 27 . In 2014, Pieper et al suggested that the overlap of the studies in an overview can be evaluated by three methods via the creation of a citation matrix 12 .…”

Section: Discussionmentioning

confidence: 99%

“…In 2021, Solmi et al stated that the overviews of SRs have an overlap that may result in the exaggeration of the qualitative conclusions and outcomes of meta‐synthesis, if performed. 27 In 2014, Pieper et al suggested that the overlap of the studies in an overview can be evaluated by three methods via the creation of a citation matrix. 12 The simplest method is to calculate the %overlap by counting the total number of overlaps and dividing them by the total number of studies.…”

Section: Discussionmentioning

confidence: 99%

Success of medicaments and techniques for pulpotomy of primary teeth: An overview of systematic reviews

Tewari

Goel

Mathur

et al. 2022

Int J Paed Dentistry

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Background Pulpotomy is an effective, vital pulp therapy procedure for caries‐affected or traumatized primary teeth. Though its efficacy is widely accepted, the superiority of medicaments and techniques remains debatable. Aim The aims of this review were to compare the success rates of various pulpotomy medicaments or techniques, assess the methodological quality of reviews, and grade the level of evidence for each comparison. Design This review followed the principles of evidence‐based medicine and recommendations for the overview of systematic reviews. An a priori protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021244489). A comprehensive literature search was performed by two reviewers, and studies were selected from various databases according to predefined criteria. Two reviewers independently used a self‐designed pilot‐tested form to extract data from the selected studies. A quality analysis was performed using A MeaSurement Tool to Assess systematic Reviews‐2 (AMSTAR‐2) and the ROBIS tool. Reporting characteristics and overlap of the primary studies were also assessed. We used modified Köhler's criteria for evaluating the quality of evidence for outcomes of included systematic reviews and meta‐analyses. Results The scrutiny of 62 full‐text articles resulted in the inclusion of eight systematic reviews. The quality of four of the reviews was found to be critically low, and the overlap of primary studies in the meta‐analyses was found to be high. Pulpotomy medicaments/techniques, except calcium hydroxide, had success rates of more than 80% for all domains and time periods. Most of the comparisons revealed no differences in the clinical, radiographic, or overall success rates. Mineral trioxide aggregate, however, was found to have better radiographic and overall success rates than calcium hydroxide at periods greater than 12 and 18 months. It also had a greater radiographic success rate than full‐strength/1:5 diluted and full‐strength formocresol at 24 months. Formocresol was found to have better overall success rates than calcium hydroxide at all time periods and better radiographic success rates at 12 months. Only 12 of the 63 comparisons had suggestive or weak evidence, whereas all others had either negligible evidence or insufficient data. Conclusions The pulpotomy medicaments/techniques, except calcium hydroxide, showed success rates of more than 80%, whereas most comparisons revealed no differences. Mineral trioxide aggregate, however, was found to be better than calcium hydroxide and formocresol in several respects. This study highlights the lack of evidence regarding the choice of pulpotomy agents for the treatment of caries‐affected primary teeth and elucidates the domains that require primary studies in the future.

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“…In short, as most studies used a cross‐sectional design, focused on candidate genes or PGS, and lacked prospective assessments of ELS, it remains unclear to what extent genes and environment interact to shape variation in subcortical brain volumes in childhood and downstream risk for psychopathology. This is important considering that the aetiology of childhood‐onset mental disorders remains largely unknown and integrative studies are considered a crucial next step to map gene‐environment interplay on brain phenotypes (Arango et al., 2021; Solmi et al., 2021).…”

Section: Introductionmentioning

confidence: 99%

Mapping gene by early life stress interactions on child subcortical brain structures: A genome‐wide prospective study

et al. 2022

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Background: Although it is well-established that both genetics and the environment influence brain development, they are typically examined separately. Here, we aimed to prospectively investigate the interactive effects of genetic variants-from a genome-wide approach-and early life stress (ELS) on child subcortical brain structures, and their association with subsequent mental health problems.Method: Primary analyses were conducted using data from the Generation R Study (N = 2257), including genotype and cumulative prenatal and postnatal ELS scores (encompassing life events, contextual risk, parental risk, interpersonal risk, direct victimisation). Neuroimaging data were collected at age 10 years, including intracranial and subcortical brain volumes (accumbens, amygdala, caudate, hippocampus, pallidum, putamen, thalamus). Genome-wide association and genome-wide-byenvironment interaction analyses (GWEIS, run separately for prenatal/postnatal ELS) were conducted for eight brain outcomes (i.e., 24 genome-wide analyses) in the Generation R Study (discovery). Polygenic scores (PGS) using the resulting weights were calculated in an independent (target) cohort (adolescent brain cognitive development Study; N = 10,751), to validate associations with corresponding subcortical volumes and examine links to later mother-reported internalising and externalising problems.Results: One GWEIS-prenatal stress locus was associated with caudate volume (rs139505895, mapping onto PRSS12 and NDST3) and two GWEIS-postnatal stress loci with the accumbens (rs2397823 and rs3130008, mapping onto CUTA, SYN-GAP1, and TABP). Functional annotation revealed that these genes play a role in neuronal plasticity and synaptic function, and have been implicated in neurodevelopmental phenotypes, for example, intellectual disability, autism, and schizophrenia. None of these associations survived a more stringent correction for multiple testing across all analysis sets. In the validation sample, all PGS genotype were associated with their respective brain volumes, but no PGS GxE associated with any Koen Bolhuis and Rosa H. Mulder shared as first author.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Risk and protective factors for mental disorders with onset in childhood/adolescence: An umbrella review of published meta-analyses of observational longitudinal studies

Cited by 19 publications

References 46 publications

Risk and protective factors for mental disorders beyond genetics: an evidence‐based atlas

Risk and protective factors for mental disorders beyond genetics: an evidence‐based atlas

Success of medicaments and techniques for pulpotomy of primary teeth: An overview of systematic reviews

Mapping gene by early life stress interactions on child subcortical brain structures: A genome‐wide prospective study

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