Prevalence and associations of fatigue in psychosis: A systematic review and meta-analysis

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research Pub Date : 2025-04-01 DOI:10.1016/j.schres.2025.03.027

Kim Poole-Wright , Aakash Patel , Fiona Gaughran , Robin Murray , Trudie Chalder

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Abstract

Background

There is increasing interest in fatigue in people with psychotic illnesses. This systematic review and meta-analysis reviewed the evidence concerning the prevalence of fatigue and associated factors in adults with psychotic illnesses.

Methods

Embase, PsycINFO, Medline and CINAHL were systematically searched for articles in English published between January 1946 to 9 October 2023. Inclusion criteria was ‘fatigue’ in adults (≥18 years old) with a confirmed ICD11 or DSM5 diagnosis of a psychotic disorder. Risk of bias was assessed with the JBI and the Newcastle-Ottawa Scale. Pooled proportions for fatigue with 95 % CI were calculated using random effects models. Heterogeneity was assessed using Cochran's Q and I² statistic and Egger's tests were conducted for publication bias.

Results

A total of 57 articles met the inclusion criteria and 7 articles (n = 1161 participants) were included for the meta-analysis of fatigue. Fatigue prevalence was 55 % (95 % CI: 37–71 %, I² = 94 %). A sensitivity analysis of the 6 studies using a valid scale (n = 711 participants) found a fatigue proportion of 59 % (95 % CI: 41–76, I² = 93 %). Eighteen studies (n = 4569 participants) were included for an analysis exploring the prevalence of antipsychotic-related fatigue, which was 20.5 % (95 % CI: 11–34 %). We found no significant difference in antipsychotic-related fatigue between studies using a valid scale (27 %, 95 % CI: 14–46, k = 7) and studies using a clinical interview (17 %, 95 % CI: 7–35 %, k = 11) p = 0.302. An Egger's test indicated no publication bias. Quality assessments for included studies revealed that 16 % were at low risk of bias, 9 % at high risk and 75 % at moderate risk. Reported associations with fatigue included sex, age, antipsychotics, distress and depression, sleep, and some negative symptoms.

Conclusions

Our study revealed that a majority of people with psychosis experience fatigue. Antipsychotics, sex, and functioning may contribute to tiredness symptoms, but further research is needed.

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来源期刊

Schizophrenia Research 医学-精神病学

CiteScore

7.50

自引率

8.90%

发文量

429

审稿时长

10.2 weeks

期刊介绍： As official journal of the Schizophrenia International Research Society (SIRS) Schizophrenia Research is THE journal of choice for international researchers and clinicians to share their work with the global schizophrenia research community. More than 6000 institutes have online or print (or both) access to this journal - the largest specialist journal in the field, with the largest readership! Schizophrenia Research''s time to first decision is as fast as 6 weeks and its publishing speed is as fast as 4 weeks until online publication (corrected proof/Article in Press) after acceptance and 14 weeks from acceptance until publication in a printed issue. The journal publishes novel papers that really contribute to understanding the biology and treatment of schizophrenic disorders; Schizophrenia Research brings together biological, clinical and psychological research in order to stimulate the synthesis of findings from all disciplines involved in improving patient outcomes in schizophrenia.