Abstract
This systematic review is to explore the prevalence of depression in patients with rheumatoid arthritis (RA) in China. Articles of prevalence rates for depression in adult RA patients published before October 2015 were identified from PubMed, Embase, The Cochrane Library, CNKI, CBM, VIP, and Wanfang database and other internet databases. Relevant journals and the recommendations of expert panels were also searched manually. Two independent reviewers searched and assessed the literature. Therelevant data were applied with Meta-Analyst 3.13 software, and the forest plot and funnel plot were performed. 21 studies with a total of 4447 patients were selected to be enrolled in this study. The prevalence of depression by analyzing the effect size was 48% [95% CI (41%, 56%)]. The prevalence of minor depression and dysthymic disorder was 30% [95%CI (23%, 38%)], and the moderate or major depression was 18% [95%CI (11%, 29%)], respectively. Subgroup analysis showed that the depression rate of female RA patients was higher than male. The depression rate in the central and western areas were higher than that of the eastern region of China, the prevalence level estimated by the Geriatric Depression Scale (GDS) was higher than estimated by other tools. Sensitivity analysis showed that the pooled effect size had good stability and reliability, To be conclusive, the prevalence rate of depression in RA patients is 48%, which suggesting that medical staff should pay more attention to depression in adult patients with RA.
Highlights
Rheumatoid arthritis (RA) is a chronic disease with an unknown etiology, presenting as systemic inflammatory autoimmune diseases, characterized by joint pain, swelling, stiffness, and deformation
Sensitivity analysis showed that the pooled effect size had good stability and reliability, To be conclusive, the prevalence rate of depression in rheumatoid arthritis (RA) patients is 48%, which suggesting that medical staff should pay more attention to depression in adult patients with RA
Estimates varied according to the way in which depression was measured, but this study used the Meta-Analyst 3.13 software to measure the prevalence of depression in RA patients in China, which the result suggests that the depressive symptoms present in 48% [95% confidence interval (CI) (41%, 56%)] in China, closing to the median 41.2% in all 21 studies.The minor depression and dysthymic disorder is present in 30% [95% CI (23%, 38%)] and moderate to major depression is present in 18% [95% CI (11%, 29%)]
Summary
Rheumatoid arthritis (RA) is a chronic disease with an unknown etiology, presenting as systemic inflammatory autoimmune diseases, characterized by joint pain, swelling, stiffness, and deformation. RA symptoms mainly include fatigue, lack of appetite, low-grade fever, and joint aches; at the late stage, the symptoms of joint, including stiffness, deformity, and even loss of function These clinical manifestations may subsequently lead to psychological distress [1]. Different studies on RA patients with depression in China reported the prevalence estimates for depression range greatly from 8% to 78% [16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33]. The importance of depression with RA patients, the aim of developing this systematic review study by performing a metaanalysis of the available data from previous studies is to comprehensively investigate pooled prevalence estimates of RA patients with depression in China
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