Review Prevalence and associations of fatigue in psychosis: A systematic review and meta-analysis 2025 Chalder et al

[Andy]

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.

Open access

 

[Utsikt]

Risk of bias was conducted by one reviewer (KPW) utilising the Newcastle-Ottawa Scale (NOS) (Wells et al., 2009) for randomised controlled trials, cohort, and case-control studies. The NOS is a star scoring system with ratings awarded in 3 broad categories covering the selection of participants (4 possible stars evaluating definition, representativeness, selection of controls, and definition of controls), comparability (2 possible stars evaluating use of controls), and exposure (3 possible stars evaluating ascertainment of exposure). Good quality studies required 3–4 stars in ‘selection’, and 1–2 stars in ‘comparability’, and 2–3 stars in ‘outcome/exposure’. Fair quality required 2 stars in ‘selection’ and 1–2 stars in ‘comparability’ and 2–3 stars in ‘outcome/exposure’. Non-randomised comparative designs and cross-sectional studies were appraised using the JBI Critical Appraisal Tools (JBI Critical Appraisal Tools, 2022). Items related to bias on this tool included “Were the participants included in any comparisons similar?” and “Were confounding factors identified?”, which demanded a ‘yes’, ‘no’, ‘unclear’ or ‘not applicable’. An overall assessment was made by assigning a grade of either ‘low quality’, ‘moderate quality’, or ‘good quality’.

Quality assessments for included studies revealed that 16 % were at low risk of bias, 9 % at high risk and 75 % at moderate risk.

I used to get stars when I did potty training. It does not seem like the researchers have fully learned how to avoid ‘accidents’ with bias yet.

 

[Utsikt]

 

[rvallee]

Antipsychotics, sex, and functioning may contribute to tiredness symptoms, but further research is needed.

About as useful as this:

Wait, no, nevermind this isn't fair, the weather rock method actually works most of the time.