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The incidence of depression and anxiety in patients with ankylosing spondylitis: a systematic review and meta-analysis

BACKGROUND: As awareness for the importance of mental health continues to expand in rheumatology, it is important to understand the epidemiology of psychiatric complications in ankylosing spondylitis (AS) with the ultimate goal of future prevention and improved quality of care. This study aims to re...

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Autores principales: Park, Jamie YE., Howren, Alyssa M., Zusman, Enav Z., Esdaile, John M., De Vera, Mary A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7050143/
https://www.ncbi.nlm.nih.gov/pubmed/32159073
http://dx.doi.org/10.1186/s41927-019-0111-6
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author Park, Jamie YE.
Howren, Alyssa M.
Zusman, Enav Z.
Esdaile, John M.
De Vera, Mary A.
author_facet Park, Jamie YE.
Howren, Alyssa M.
Zusman, Enav Z.
Esdaile, John M.
De Vera, Mary A.
author_sort Park, Jamie YE.
collection PubMed
description BACKGROUND: As awareness for the importance of mental health continues to expand in rheumatology, it is important to understand the epidemiology of psychiatric complications in ankylosing spondylitis (AS) with the ultimate goal of future prevention and improved quality of care. This study aims to review evidence on the incidence and determinants of depression and/or anxiety among patients with AS. METHODS: We searched Medline, Embase, Cochrane Database of Systematic Reviews, CINAHL Complete, and PsycINFO for full-length observational studies that involved a sample or population of patients with AS and assessed depression and/or anxiety. Primary outcomes extracted were: 1) risk estimates for depression and/or anxiety (e.g., relative risk [RR]); and 2) determinants or factors identified as independent predictors of depression and/or anxiety using multivariable regression approaches and corresponding estimates (e.g., odds ratios [OR]). Where relevant, we pooled estimates using random effects models. RESULTS: Out of 783 titles from our search strategy, we reviewed 39 manuscripts. Four studies assessed the incidence of depression and meta-analyzing reported estimates from three of these studies yielded a pooled RR of 1.51 (95% CI 1.28 to 1.79). Differences in risk of depression among men and women with AS were inconclusive, suggesting need for further study. The incidence of anxiety was comparatively less studied with only one included study reporting a hazard ratio of 1.85 (95% CI 1.37 to 2.49). Education level was a key determinant, with lower levels associated with higher odds of depression (OR 6.65; 9% CI 1.36 to 32.51) and anxiety (OR 9.31; 9% CI 1.39 to 62.19) among AS patients. CONCLUSIONS: Our systematic review and meta-analysis shows an increased risk of depression and anxiety among patients with AS. These findings suggest the importance of monitoring and care for psychiatric conditions in AS.
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spelling pubmed-70501432020-03-10 The incidence of depression and anxiety in patients with ankylosing spondylitis: a systematic review and meta-analysis Park, Jamie YE. Howren, Alyssa M. Zusman, Enav Z. Esdaile, John M. De Vera, Mary A. BMC Rheumatol Research Article BACKGROUND: As awareness for the importance of mental health continues to expand in rheumatology, it is important to understand the epidemiology of psychiatric complications in ankylosing spondylitis (AS) with the ultimate goal of future prevention and improved quality of care. This study aims to review evidence on the incidence and determinants of depression and/or anxiety among patients with AS. METHODS: We searched Medline, Embase, Cochrane Database of Systematic Reviews, CINAHL Complete, and PsycINFO for full-length observational studies that involved a sample or population of patients with AS and assessed depression and/or anxiety. Primary outcomes extracted were: 1) risk estimates for depression and/or anxiety (e.g., relative risk [RR]); and 2) determinants or factors identified as independent predictors of depression and/or anxiety using multivariable regression approaches and corresponding estimates (e.g., odds ratios [OR]). Where relevant, we pooled estimates using random effects models. RESULTS: Out of 783 titles from our search strategy, we reviewed 39 manuscripts. Four studies assessed the incidence of depression and meta-analyzing reported estimates from three of these studies yielded a pooled RR of 1.51 (95% CI 1.28 to 1.79). Differences in risk of depression among men and women with AS were inconclusive, suggesting need for further study. The incidence of anxiety was comparatively less studied with only one included study reporting a hazard ratio of 1.85 (95% CI 1.37 to 2.49). Education level was a key determinant, with lower levels associated with higher odds of depression (OR 6.65; 9% CI 1.36 to 32.51) and anxiety (OR 9.31; 9% CI 1.39 to 62.19) among AS patients. CONCLUSIONS: Our systematic review and meta-analysis shows an increased risk of depression and anxiety among patients with AS. These findings suggest the importance of monitoring and care for psychiatric conditions in AS. BioMed Central 2020-03-02 /pmc/articles/PMC7050143/ /pubmed/32159073 http://dx.doi.org/10.1186/s41927-019-0111-6 Text en © The Author(s) 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Park, Jamie YE.
Howren, Alyssa M.
Zusman, Enav Z.
Esdaile, John M.
De Vera, Mary A.
The incidence of depression and anxiety in patients with ankylosing spondylitis: a systematic review and meta-analysis
title The incidence of depression and anxiety in patients with ankylosing spondylitis: a systematic review and meta-analysis
title_full The incidence of depression and anxiety in patients with ankylosing spondylitis: a systematic review and meta-analysis
title_fullStr The incidence of depression and anxiety in patients with ankylosing spondylitis: a systematic review and meta-analysis
title_full_unstemmed The incidence of depression and anxiety in patients with ankylosing spondylitis: a systematic review and meta-analysis
title_short The incidence of depression and anxiety in patients with ankylosing spondylitis: a systematic review and meta-analysis
title_sort incidence of depression and anxiety in patients with ankylosing spondylitis: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7050143/
https://www.ncbi.nlm.nih.gov/pubmed/32159073
http://dx.doi.org/10.1186/s41927-019-0111-6
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