Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010
TL;DR: Prevalence and severity of health loss were weakly correlated and age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010, but population growth and ageing have increased YLD numbers and crude rates over the past two decades.
About: This article is published in The Lancet.The article was published on 2012-12-15 and is currently open access. It has received 7021 citations till now. The article focuses on the topics: Years of potential life lost & Global health.
Citations
More filters
TL;DR: The result showed a pattern of rising global migraine prevalence, which affects one in ten people worldwide featuring recent rise among females, students, and urban residents.
256 citations
TL;DR: The estimates suggest that cannabis use as a risk factor for schizophrenia is not a major contributor to population-level disease burden and cannabis dependence is a disorder primarily experienced by young adults, especially in higher income countries.
Abstract: Aims
Estimate the prevalence of cannabis dependence and its contribution to the global burden of disease.
254 citations
TL;DR: Personality is suggested to be a major risk factor for depression but large‐scale individual participant meta‐analyses on this topic are lacking.
Abstract: Depression is a highly prevalent and often long-term mental disorder reducing quality of life and causing increased health care costs, loss of productive working days and disability 1. Although the aetiology of depression is multifactorial, personality is among the important characteristics that have been hypothesized to predict depression. In addition, personality dysfunction has been associated with poor outcome of depression, increased risk of suicide, and extensive use of treatment 2, 3. Different personality traits have been associated with depressive disorders, e.g., major depressive disorder (MDD), and depressive symptoms 4-6, and at least six theoretical models (i.e., common cause, spectrum, vulnerability, precursor, pathoplasty, and scar) have been proposed to explain these associations 7-11. However, it has been argued that research in this field may be biased in favour of publishing positive results 12, 13. Thus, published evidence may have overestimated the strength of the personality-depression association. In addition, only few studies have taken into account reverse causation, that is, that depressive symptoms might also predict change in personality.
The largest meta-analytic review of published data to date included up to 14 563 patients and 60 576 controls and reported that individuals suffering from depressive disorders, i.e., MDD, unipolar depression, and dysthymic disorder, had higher levels of neuroticism and lower levels of both extraversion and conscientiousness when compared to healthy controls 5. A longitudinal association between high neuroticism and depressive symptoms or depression was observed in another recent meta-analysis that examined the relationship between neuroticism and depressive symptoms in prospective studies 6. However, other personality dimensions were not included in meta-analyses of prospective studies. In addition, the degree and direction of potential publication bias in the literature-based meta-analyses has not been examined 12, 14, 15. It has also been shown that depressive symptoms might predict change in personality 16. Recently, in a sample of 1739 Finnish men and women reciprocal relationship between negative emotionality, i.e., neuroticism, and depressive symptoms was found over 15 years of follow-up 17. However, it is not known whether these results can be generalized to other populations.
To address these limitations, we pooled unpublished data from 10 prospective cohort studies with 117 899 participants for an individual-participants meta-analysis to investigate the possible two-way relationship between personality traits of the Five-factor model of personality with depressive symptoms. The Five-factor model of personality includes five personality traits (extraversion, neuroticism, agreeableness, conscientiousness and openness to experience) and is currently the most widely used theory of personality 18. Based on previous findings 5,6, we hypothesized that low extraversion, high neuroticism and low conscientiousness may be associated with increased depressive symptoms. We also expected that the association between high neuroticism and depressive symptoms would be stronger than the associations between low extraversion and low conscientiousness with depressive symptoms. As age, gender, education, ethnicity, and marital status have also been linked to depressive symptoms 19, 20, we tested whether these factors might moderate the association between personality and depressive symptoms.
254 citations
TL;DR: There is some evidence (very low to moderate quality) for short-term efficacy (for both pain and function) of opioids to treat CLBP compared to placebo, and the included trials in this review had high drop-out rates, were of short duration, and had limited interpretability of functional improvement.
Abstract: Background
The use of opioids in the long-term management of chronic low-back pain (CLBP) has increased dramatically. Despite this trend, the benefits and risks of these medications remain unclear. This review is an update of a Cochrane review first published in 2007.
Objectives
To determine the efficacy of opioids in adults with CLBP.
Search methods
We electronically searched the Cochrane Back Review Group's Specialized Register, CENTRAL, CINAHL and PsycINFO, MEDLINE, and EMBASE from January 2006 to October 2012. We checked the reference lists of these trials and other relevant systematic reviews for potential trials for inclusion.
Selection criteria
We included randomized controlled trials (RCTs) that assessed the use of opioids (as monotherapy or in combination with other therapies) in adults with CLBP that were at least four weeks in duration. We included trials that compared non-injectable opioids to placebo or other treatments. We excluded trials that compared different opioids only.
Data collection and analysis
Two authors independently assessed the risk of bias and extracted data onto a pre-designed form. We pooled results using Review Manager (RevMan) 5.2. We reported on pain and function outcomes using standardized mean difference (SMD) or risk ratios with 95% confidence intervals (95% CI). We used absolute risk difference (RD) with 95% CI to report adverse effects.
Main results
We included 15 trials (5540 participants). Tramadol was examined in five trials (1378 participants); it was found to be better than placebo for pain (SMD -0.55, 95% CI -0.66 to -0.44; low quality evidence) and function (SMD -0.18, 95% CI -0.29 to -0.07; moderate quality evidence). Transdermal buprenorphine (two trials, 653 participants) may make little difference for pain (SMD -2.47, 95%CI -2.69 to -2.25; very low quality evidence), but no difference compared to placebo for function (SMD -0.14, 95%CI -0.53 to 0.25; very low quality evidence). Strong opioids (morphine, hydromorphone, oxycodone, oxymorphone, and tapentadol), examined in six trials (1887 participants), were better than placebo for pain (SMD -0.43, 95%CI -0.52 to -0.33; moderate quality evidence) and function (SMD -0.26, 95% CI -0.37 to -0.15; moderate quality evidence). One trial (1583 participants) demonstrated that tramadol may make little difference compared to celecoxib (RR 0.82, 95% CI 0.76 to 0.90; very low quality evidence) for pain relief. Two trials (272 participants) found no difference between opioids and antidepressants for either pain (SMD 0.21, 95% CI -0.03 to 0.45; very low quality evidence), or function (SMD -0.11, 95% -0.63 to 0.42; very low quality evidence). The included trials in this review had high drop-out rates, were of short duration, and had limited interpretability of functional improvement. They did not report any serious adverse effects, risks (addiction or overdose), or complications (sleep apnea, opioid-induced hyperalgesia, hypogonadism). In general, the effect sizes were medium for pain and small for function.
Authors' conclusions
There is some evidence (very low to moderate quality) for short-term efficacy (for both pain and function) of opioids to treat CLBP compared to placebo. The very few trials that compared opioids to non-steroidal anti-inflammatory drugs (NSAIDs) or antidepressants did not show any differences regarding pain and function. The initiation of a trial of opioids for long-term management should be done with extreme caution, especially after a comprehensive assessment of potential risks. There are no placebo-RCTs supporting the effectiveness and safety of long-term opioid therapy for treatment of CLBP.
252 citations
VU University Amsterdam1, Oregon Health & Science University2, VU University Medical Center3, Monash University4, Cochrane Collaboration5, University of Sydney6, Keele University7, Oslo and Akershus University College of Applied Sciences8, Erasmus University Rotterdam9, Dartmouth–Hitchcock Medical Center10, Leiden University Medical Center11, University of Washington12
TL;DR: Overall consensus was reached for the inclusion of three domains in this COS: ‘physical functioning’, ‘pain intensity” and ‘health-related quality of life’ and the domain ‘number of deaths’.
Abstract: Purpose
Inconsistent reporting of outcomes in clinical trials of patients with non-specific low back pain (NSLBP) hinders comparison of findings and the reliability of systematic reviews. A core outcome set (COS) can address this issue as it defines a minimum set of outcomes that should be reported in all clinical trials. In 1998, Deyo et al. recommended a standardized set of outcomes for LBP clinical research. The aim of this study was to update these recommendations by determining which outcome domains should be included in a COS for clinical trials in NSLBP.
251 citations
References
More filters
TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex, using the Cause of Death Ensemble model.
11,809 citations
Book•
31 Dec 1997
TL;DR: The aim of this study was to establish a database of histological groups and to provide a level of consistency and quality of data that could be applied in the design of future registries.
Abstract: 1. Techniques of registration 2. Classification and coding 3. Histological groups 4. Comparability and quality of data 5. Data processing 6. Age-standardization 7. Incidence data by site and sex for each registry 8. Summary tables presenting age-standardized rates 9. Data on histological type for selected sites
10,160 citations
TL;DR: Notably, major depressive disorder is a common disorder, widely distributed in the population, and usually associated with substantial symptom severity and role impairment, and while the recent increase in treatment is encouraging, inadequate treatment is a serious concern.
Abstract: ContextUncertainties exist about prevalence and correlates of major depressive
disorder (MDD).ObjectiveTo present nationally representative data on prevalence and correlates
of MDD by Diagnostic and Statistical Manual of Mental Disorders,
Fourth Edition (DSM-IV) criteria, and on study
patterns and correlates of treatment and treatment adequacy from the recently
completed National Comorbidity Survey Replication (NCS-R).DesignFace-to-face household survey conducted from February 2001 to December
2002.SettingThe 48 contiguous United States.ParticipantsHousehold residents ages 18 years or older (N = 9090) who responded
to the NCS-R survey.Main Outcome MeasuresPrevalence and correlates of MDD using the World Health Organization's
(WHO) Composite International Diagnostic Interview (CIDI), 12-month severity
with the Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR),
the Sheehan Disability Scale (SDS), and the WHO disability assessment scale
(WHO-DAS). Clinical reinterviews used the Structured Clinical Interview for DSM-IV.ResultsThe prevalence of CIDI MDD for lifetime was 16.2% (95% confidence interval
[CI], 15.1-17.3) (32.6-35.1 million US adults) and for 12-month was 6.6% (95%
CI, 5.9-7.3) (13.1-14.2 million US adults). Virtually all CIDI 12-month cases
were independently classified as clinically significant using the QIDS-SR,
with 10.4% mild, 38.6% moderate, 38.0% severe, and 12.9% very severe. Mean
episode duration was 16 weeks (95% CI, 15.1-17.3). Role impairment as measured
by SDS was substantial as indicated by 59.3% of 12-month cases with severe
or very severe role impairment. Most lifetime (72.1%) and 12-month (78.5%)
cases had comorbid CIDI/DSM-IV disorders, with MDD
only rarely primary. Although 51.6% (95% CI, 46.1-57.2) of 12-month cases
received health care treatment for MDD, treatment was adequate in only 41.9%
(95% CI, 35.9-47.9) of these cases, resulting in 21.7% (95% CI, 18.1-25.2)
of 12-month MDD being adequately treated. Sociodemographic correlates of treatment
were far less numerous than those of prevalence.ConclusionsMajor depressive disorder is a common disorder, widely distributed in
the population, and usually associated with substantial symptom severity and
role impairment. While the recent increase in treatment is encouraging, inadequate
treatment is a serious concern. Emphasis on screening and expansion of treatment
needs to be accompanied by a parallel emphasis on treatment quality improvement.
7,706 citations
Book•
01 Jan 1996
TL;DR: This is the first in a planned series of 10 volumes that will attempt to "summarize epidemiological knowledge about all major conditions and most risk factors" and use historical trends in main determinants to project mortality and disease burden forward to 2020.
Abstract: This is the first in a planned series of 10 volumes that will attempt to "summarize epidemiological knowledge about all major conditions and most risk factors;...generate assessments of numbers of deaths by cause that are consistent with the total numbers of deaths by age sex and region provided by demographers;...provide methodologies for and assessments of aggregate disease burden that combine--into the Disability-Adjusted Life Year or DALY measure--burden from premature mortality with that from living with disability; and...use historical trends in main determinants to project mortality and disease burden forward to 2020." This first volume includes chapters summarizing results from the project as a whole. (EXCERPT)
7,154 citations