BACKGROUND The mental health conditions of allergic diseases have been investigated, but the consistency and magnitude of their effects are unclear. The aim of this umbrella review was to systematically evaluate the published evidence on allergic diseases and mental health conditions to establish a new hierarchy of evidence and identify gaps in this area of research. METHODS We systematically searched PubMed, Embase, Web of Science, and the Cochrane Database of Systematic Reviews from database inception to April 30, 2024. We included systematic reviews that conducted meta-analyses that examined the association of allergic diseases and mental health conditions. We calculated summary effect estimates (odds ratios), 95% confidence intervals, I2 statistics, 95% prediction intervals, small study effects, and excess significance biases. We used AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews 2) to appraise the methodologic quality of the included studies. RESULTS We identified 21 eligible articles, which yielded 37 associations (348,405,029 total population) of allergic diseases and mental health conditions. The credibility of evidence was convincing (class I) for asthma and risk of attention-deficit/hyperactivity disorder (odds ratio 1.34, 95% confidence interval 1.24-1.44); and highly suggestive (class II) for allergic rhinitis and risk of tic disorders (2.61, 1.90-3.57), allergic rhinitis and risk of sleep disorders (2.17, 1.87-2.53), food allergy and risk of autism spectrum disorder (2.79, 2.08-3.75), atopic dermatitis and risk of depression (1.60, 1.43-1.79), atopic dermatitis and risk of anxiety (1.62 1.42-1.85), atopic dermatitis and risk of attention-deficit/hyperactivity disorder (1.28, 1.18-1.40), atopic dermatitis and risk of suicidal ideation (1.44, 1.25-1.65), asthma and risk of depression (1.64, 1.50-1.78), asthma and risk of anxiety (1.95, 1.68-2.26), asthma and risk of tic disorders (1.90, 1.57-2.30), asthma and risk of suicidal ideation (1.52, 1.37-1.70), and asthma and risk of suicide attempts (1.60, 1.33-1.92). CONCLUSIONS Allergic diseases are associated with increased risk of a range of mental health conditions, with the most convincing evidence for asthma. However, these associations do not imply causality, and there is large heterogeneity in these associations, which requires high-quality primary studies to identify causality and strength of evidence.

中文翻译：

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过敏性疾病与心理健康状况之间的关联：伞式评论。


背景 已经调查了过敏性疾病的心理健康状况，但其影响的一致性和程度尚不清楚。本伞式综述的目的是系统评价已发表的关于过敏性疾病和心理健康状况的证据，以建立新的证据层次结构并确定该研究领域的差距。方法 我们系统检索了从数据库建库到 2024 年 4 月 30 日的 PubMed、Embase、Web of Science 和 Cochrane 系统综述数据库。我们纳入了进行meta分析的系统评价，这些分析考察了过敏性疾病与心理健康状况之间的关联。我们计算了汇总效应估计值（比值比）、95% 置信区间、I2 统计量、95% 预测区间、小研究效应和超额显著性偏倚。我们使用 AMSTAR 2 （A Measurement Tool to Assess Systematic Reviews 2） 来评估纳入研究的方法学质量。结果 我们确定了 21 篇符合条件的文章，产生了 37 个过敏性疾病和心理健康状况的关联 （348,405,029 总人口）。哮喘和注意力缺陷/多动障碍风险的证据可信度令人信服（I 类）（比值比 1.34,95% 置信区间 1.24-1.44）;高度提示（II 类）过敏性鼻炎和抽动障碍风险 （2.61， 1.90-3.57）、过敏性鼻炎和睡眠障碍风险 （2.17， 1.87-2.53）、食物过敏和自闭症谱系障碍风险 （2.79， 2.08-3.75）、特应性皮炎和抑郁症风险 （1.60， 1.43-1.79）、特应性皮炎和焦虑风险 （1.62 1.42-1.85）、特应性皮炎和注意力缺陷/多动障碍风险 （1.28， 1.18-1.40）、特应性皮炎和自杀意念风险 （1.44， 1.25-1.65）、哮喘和抑郁风险 （1.64， 1.50-1.78）、哮喘和焦虑风险 （1.95， 1.68-2.26）、哮喘和抽动障碍风险 （1.90， 1.57-2.30）、哮喘和自杀意念风险 （1.52， 1.37-1.70） 和哮喘和自杀未遂风险 （1.60， 1.33-1.92）。结论 过敏性疾病与一系列心理健康状况的风险增加有关，哮喘的证据最令人信服。然而，这些关联并不意味着因果关系，并且这些关联存在很大的异质性，这需要高质量的原始研究来确定因果关系和证据强度。