Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA.
Haemophilia. 2020 May;26(3):431-442. doi: 10.1111/hae.13960. Epub 2020 Apr 19.
Despite significant advances in morbidity and mortality outcomes, quality of life for people with haemophilia (PWH) remains compromised. Underrecognized and undertreated mental health disorders decrease quality of life; however, reports are inconsistent regarding the true prevalence of mental health disorders in PWH.
We conducted a systematic literature search of Ovid MEDLINE, EMBASE, Psychinfo and the Cochrane Library, and hand searched the journal Haemophilia to identify records and subsequently conducted a meta-analysis to determine the prevalence of depression, anxiety and attention deficit hyperactivity disorder (ADHD) in patients with congenital haemophilia.
Our search strategy identified 2315 records, and 28 studies met eligibility criteria. Meta-analysis demonstrated that PWH are at increased risk of depression (odds ratio (OR) 2.45; 95% confidence interval (CI) 1.64-3.68), anxiety (OR 1.74, 95% CI 1.01-3.00), anxiety/depression (OR 2.60, 95% CI 2.35-2.87) and ADHD (OR 3.48, 95% CI 1.74-6.96). We found considerable heterogeneity among the studies likely due to differences in assessment tools, populations studied and year of publication. This suggests that standardized tools to diagnose mental health disorders in PWH are needed. Additionally, high-quality studies investigating mental health disorders in PWH are necessary to adequately document the prevalence of these disorders.
Overall, our meta-analysis suggests that the prevalence of depression, anxiety and ADHD across decades is significantly increased in PWH compared to the general population.
尽管发病率和死亡率有了显著改善，但血友病患者（PWH）的生活质量仍然受到影响。未被充分认识和治疗的心理健康障碍会降低生活质量；然而，关于 PWH 中心理健康障碍的真实患病率的报告并不一致。
我们对 Ovid MEDLINE、EMBASE、Psychinfo 和 Cochrane 图书馆进行了系统文献检索，并对手头的《血友病》杂志进行了检索，以确定记录，随后进行了荟萃分析，以确定先天性血友病患者中抑郁、焦虑和注意缺陷多动障碍（ADHD）的患病率。
我们的搜索策略确定了 2315 条记录，有 28 项研究符合入选标准。荟萃分析表明，PWH 患抑郁的风险增加（比值比（OR）2.45；95%置信区间（CI）1.64-3.68）、焦虑（OR 1.74，95% CI 1.01-3.00）、焦虑/抑郁（OR 2.60，95% CI 2.35-2.87）和 ADHD（OR 3.48，95% CI 1.74-6.96）。我们发现这些研究之间存在很大的异质性，这可能是由于评估工具、研究人群和发表年份的不同。这表明需要标准化工具来诊断 PWH 中的心理健康障碍。此外，需要高质量的研究来调查 PWH 中的心理健康障碍，以充分记录这些障碍的患病率。
总体而言，我们的荟萃分析表明，与普通人群相比，PWH 中抑郁、焦虑和 ADHD 的患病率在几十年中显著增加。
