The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis

TLDR: Depression is highly prevalent in RA and associated with poorer RA outcomes, which suggests that optimal care of RA patients may include the detection and management of depression.

Abstract: Objective There is substantial uncertainty regarding the prevalence of depression in RA We conducted a systematic review aiming to describe the prevalence of depression in RA Methods Web of Science, PsycINFO, CINAHL, Embase, Medline and PubMed were searched for cross-sectional studies reporting a prevalence estimate for depression in adult RA patients Studies were reviewed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and a meta-analysis was performed Results A total of 72 studies, including 13 189 patients, were eligible for inclusion in the review Forty-three methods of defining depression were reported Meta-analyses revealed the prevalence of major depressive disorder to be 168% (95% CI 10%, 24%) According to the PHQ-9, the prevalence of depression was 388% (95% CI 34%, 43%), and prevalence levels according to the HADS with thresholds of 8 and 11 were 342% (95% CI 25%, 44%) and 148% (95% CI 12%, 18%), respectively The main influence on depression prevalence was the mean age of the sample Conclusion Depression is highly prevalent in RA and associated with poorer RA outcomes This suggests that optimal care of RA patients may include the detection and management of depression