Department of Psychological Medicine, Institute of Psychiatry, King's College London, Weston Education Centre, 10 Cutcombe Road, London SE5 9RJ, UK.
Rheumatology (Oxford). 2013 Dec;52(12):2136-48. doi: 10.1093/rheumatology/ket169. Epub 2013 Sep 3.
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.
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.
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 16.8% (95% CI 10%, 24%). According to the PHQ-9, the prevalence of depression was 38.8% (95% CI 34%, 43%), and prevalence levels according to the HADS with thresholds of 8 and 11 were 34.2% (95% CI 25%, 44%) and 14.8% (95% CI 12%, 18%), respectively. The main influence on depression prevalence was the mean age of the sample.
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.
类风湿关节炎（RA）患者中抑郁症的患病率存在较大不确定性。本研究旨在对 RA 患者中抑郁症的患病率进行描述。
在 Web of Science、PsycINFO、CINAHL、Embase、Medline 和 PubMed 中检索了报告成人 RA 患者抑郁症患病率估计值的横断面研究。研究按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行了审查，并进行了荟萃分析。
共有 72 项研究（包括 13189 名患者）符合纳入标准。共报告了 43 种定义抑郁症的方法。荟萃分析显示，重度抑郁症的患病率为 16.8%（95%CI，10%，24%）。根据 PHQ-9，抑郁症的患病率为 38.8%（95%CI，34%，43%），根据 HADS 阈值为 8 和 11 的患病率分别为 34.2%（95%CI，25%，44%）和 14.8%（95%CI，12%，18%）。对抑郁症患病率的主要影响因素是样本的平均年龄。
RA 患者中抑郁症的患病率较高，且与 RA 结局较差相关。这表明，RA 患者的最佳治疗可能包括抑郁症的检测和管理。
