Global estimates of natural, unnatural, and all-cause mortality in patients with personality disorders: A meta-analysis of longitudinal studies and meta-regression of potential moderators in a sample of 34 million people

IF 3.7 2区医学 Q1 PSYCHIATRY

General hospital psychiatry Pub Date : 2025-09-22 DOI:10.1016/j.genhosppsych.2025.09.005

Saeid Komasi , Ali Zakiei , Gerald J. Haeffel , Federico Amianto , Jouko Miettunen , Carla Sharp

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引用次数: 0

Abstract

Introduction

Personality disorders (PDs) influence various life aspects and health outcomes, necessitating a deeper understanding of how they affect mortality rates and the factors that contribute to these differences. This meta-analysis aims to make global estimates of natural, unnatural, and all-cause mortality in patients with PD by synthesizing data from longitudinal studies and identifying potential moderators influencing these outcomes

Methods

This meta-analysis followed PRISMA guidelines (PROSPERO-CRD42025636341), including a systematic search of English-language records from PubMed, Scopus, PsycNET, and Google scholar. Standardized mortality ratio (SMR) for natural, unnatural, and all-cause mortality was calculated using the random-effects method. We used meta-regression and subgroup analyses to explore potential sources of heterogeneity. Publication bias and the risk of bias also were evaluated

Results

Approximately 2,368,000 deaths were reported by 35 eligible studies. The pooled SMR for all-cause mortality was 4.16 (95 % CI: 3.74–4.62), indicating a significantly elevated risk. The SMR for natural causes of death was 2.95 (95 % CI: 2.70–3.21) whereas the SMR for unnatural causes of death (suicide being the primary contributor = 22.69) was 14.27 (95 % CI: 12.79–15.92). We found that 12 potential moderators differentially affected each of the natural, unnatural, and all causes of death

Conclusions

This meta-analysis highlights a significantly elevated mortality risk in patients with PD, particularly from unnatural causes like suicide. Identifying key moderators can guide targeted interventions and inform health policies to enhance care and prevention strategies for this vulnerable population, emphasizing the need for ongoing research into mortality trends

查看原文本刊更多论文

人格障碍患者自然、非自然和全因死亡率的全球估计：对3400万人样本中潜在调节因子的纵向研究和元回归的荟萃分析

人格障碍（pd）影响生活的各个方面和健康结果，需要更深入地了解它们如何影响死亡率以及导致这些差异的因素。本荟萃分析旨在通过综合来自纵向研究的数据，并确定影响这些结果的潜在调节因子，对PD患者的自然、非自然和全因死亡率进行全球估计。方法：本荟萃分析遵循PRISMA指南（PROSPERO-CRD42025636341），包括对PubMed、Scopus、PsycNET和谷歌scholar的英语记录进行系统搜索。采用随机效应法计算自然、非自然和全因死亡率的标准化死亡率（SMR）。我们使用元回归和亚组分析来探索异质性的潜在来源。还评估了发表偏倚和偏倚风险。结果：35项符合条件的研究报告了大约2,368,000例死亡。全因死亡率的总SMR为4.16 (95% CI: 3.74-4.62)，表明风险显著升高。自然死亡原因的SMR为2.95 (95% CI: 2.70-3.21)，而非自然死亡原因（自杀是主要因素= 22.69）的SMR为14.27 （95% CI: 12.79-15.92）。我们发现12种潜在调节因子对自然、非自然和所有死因的影响不同。结论：该荟萃分析强调了PD患者的死亡率风险显著升高，尤其是自杀等非自然原因。确定关键的调节因素可以指导有针对性的干预措施，并为卫生政策提供信息，以加强针对这一弱势群体的护理和预防战略，同时强调需要对死亡率趋势进行持续研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

General hospital psychiatry 医学-精神病学

CiteScore

9.60

自引率

2.90%

发文量

125

审稿时长

20 days

期刊介绍： General Hospital Psychiatry explores the many linkages among psychiatry, medicine, and primary care. In emphasizing a biopsychosocial approach to illness and health, the journal provides a forum for professionals with clinical, academic, and research interests in psychiatry''s role in the mainstream of medicine.