Nanthakumar Shenooka, Bucks Romola S, Skinner Timothy C
School of Psychology, The University of Western Australia.
School of Psychological and Clinical Sciences, Charles Darwin University.
Health Psychol. 2016 May;35(5):423-32. doi: 10.1037/hea0000280. Epub 2015 Nov 2.
Depression is common in chronic illness, albeit prevalence can be highly variable. This variability may be a function of symptom overlap between depression and chronic illness. Using Obstructive Sleep Apnoea (OSA) as an exemplar, this meta-analysis explored whether the proportion of overlapping symptoms between OSA and depression, within different depression questionnaires, moderates prevalence estimates.
A systematic search identified 13 studies meeting eligibility criteria.
Based on depression questionnaires, the prevalence of depression in OSA ranged from 8% to 68%, reflecting marked heterogeneity. Prevalence estimates based on questionnaires with greater symptom overlap between OSA and depression were higher, whereas questionnaires with a higher proportion of anhedonia symptoms were associated with lower prevalence estimates.
Overall, these data suggest that when using depression questionnaires to assess the prevalence of depression in OSA, questionnaires that have a lower proportion of symptom overlap between OSA and depression, as well as a higher proportion of anhedonia symptoms, reduce the likelihood of overestimating the prevalence of depression in OSA. This study has implications for other chronic illnesses with symptom overlap with depression, for example diabetes, chronic kidney disease, or heart disease, as well as suggesting that depression questionnaires are not equally appropriate for assessing depression symptomatology in chronic illness populations.
抑郁症在慢性病中很常见，尽管其患病率差异很大。这种差异可能是抑郁症与慢性病症状重叠的结果。本荟萃分析以阻塞性睡眠呼吸暂停（OSA）为例，探讨了在不同的抑郁问卷中，OSA与抑郁症重叠症状的比例是否会影响患病率估计。
通过系统检索确定了13项符合纳入标准的研究。
基于抑郁问卷，OSA患者中抑郁症的患病率在8%至68%之间，反映出显著的异质性。基于OSA与抑郁症症状重叠较多的问卷得出的患病率估计较高，而快感缺失症状比例较高的问卷得出的患病率估计较低。
总体而言，这些数据表明，在使用抑郁问卷评估OSA患者抑郁症的患病率时，OSA与抑郁症症状重叠比例较低且快感缺失症状比例较高的问卷，可降低高估OSA患者抑郁症患病率的可能性。本研究对其他与抑郁症有症状重叠的慢性病（如糖尿病、慢性肾病或心脏病）具有启示意义，同时也表明抑郁问卷在评估慢性病患者的抑郁症状方面并非同样适用。
