The significantly increased morbidity and death from somatic causes in people with mental illnesses may be caused by nucleic acid damage from oxidative stress (NA-OXS), which was thought to be a molecular process. to carefully collect and examine data on NA-OXS across the diagnostic range for mental disorders.
From the start through November 16, 2021, the databases PubMed, Embase, and PsycINFO were searched. Additionally, reference lists of pertinent papers were manually searched. The main inclusion criteria for the meta-analysis were the adult human study population, measurement of any marker of DNA or RNA damage from oxidative stress, and either a cross-sectional design comparing patients with psychiatric disorders (any diagnosis) with a control group or prospective intervention. Two writers reviewed the studies, and the relevant publications were thoroughly read and evaluated for eligibility by two senior authors. The standards set out by Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were adhered to. Two writers carried out data extraction with the assistance of a more experienced coauthor where necessary. Meta-analyses with several levels and random factors were used to combine the data. The predetermined hypothesis was that elevated NA-OXS levels are seen in those with mental illnesses. The primary outcome was the standardized mean differences (SMDs) in nucleic acid oxidation indicators across diagnostic groupings between patients and controls. Combinations of biological matrices and nucleic acids were used in different analyses.
About 82 studies met the requirements for inclusion, with 205 comparisons between the patient and control groups and a total of 10,151 patients and 10,532 control observations. Overall, the findings demonstrated that individuals with mental illnesses had greater NA-OXS levels across matrices and molecules than controls. For blood cell DNA indicators, the pooled effect sizes varied from extremely large (SMD=1.12 [95% CI, 0.69-1.55; P<.001) to moderate for urine DNA markers (SMD=0.44 [95% CI, 0.20-0.68]; P<.001)). Patients with dementias had the highest levels of NA-OXS, followed by those with psychotic and bipolar illnesses. Excluding low-quality papers from sensitivity analysis had no significant impact on the findings. There weren’t enough intervention studies for the meaningful meta-analysis, and they were too diverse.
The findings of the meta-analysis point to a correlation between elevated NA-OXS levels in people with mental disorders across the diagnostic range. NA-OXS may influence somatic morbidity and mortality in people with mental illnesses.