Evidence map›Paper›PMID 34030749›Full record

SynthesisPsychological medicine2021

Using Mendelian randomization analysis to better understand the relationship between mental health and substance use: a systematic review.

Jorien L Treur, Marcus R Munafò, Emma Logtenberg, Reinout W Wiers, Karin J H Verweij

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Psychological medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 8 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jorien L TreurDepartment of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Marcus R MunafòSchool of Psychological Science, University of Bristol, Bristol, UK.
Emma LogtenbergDepartment of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Reinout W WiersAddiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands.
Karin J H VerweijDepartment of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Funding

Department of HealthMedical Research Council MC_UU_00011/7
6 · The paper itself

Abstract

backgroundPoor mental health has consistently been associated with substance use (smoking, alcohol drinking, cannabis use, and consumption of caffeinated drinks). To properly inform public health policy it is crucial to understand the mechanisms underlying these associations, and most importantly, whether or not they are causal.

methodsIn this pre-registered systematic review, we assessed the evidence for causal relationships between mental health and substance use from Mendelian randomization (MR) studies, following PRISMA. We rated the quality of included studies using a scoring system that incorporates important indices of quality, such as the quality of phenotype measurement, instrument strength, and use of sensitivity methods.

resultsSixty-three studies were included for qualitative synthesis. The final quality rating was '-' for 16 studies, '- +' for 37 studies, and '+'for 10 studies. There was robust evidence that higher educational attainment decreases smoking and that there is a bi-directional, increasing relationship between smoking and (symptoms of) mental disorders. Another robust finding was that higher educational attainment increases alcohol use frequency, but decreases binge-drinking and alcohol use problems, and that mental disorders causally lead to more alcohol drinking without evidence for the reverse.

conclusionsThe current MR literature increases our understanding of the relationship between mental health and substance use. Bi-directional causal relationships are indicated, especially for smoking, providing further incentive to strengthen public health efforts to decrease substance use. Future MR studies should make use of large(r) samples in combination with detailed phenotypes, a wide range of sensitivity methods, and triangulate with other research methods.

Indexed as

CausalityMendelian Randomization AnalysisAlcoholismHumansMental DisordersSmokingSubstance-Related Disordersalcoholcaffeinecannabiscognitive functioningMendelian randomizationmental disorderssmokingsubstance useSystematic review

Identifiers

PMID34030749
PMCPMC8327626

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.