Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada.
Int J Environ Res Public Health. 2020 Dec 15;17(24):9376. doi: 10.3390/ijerph17249376.
A systematic review and meta-analysis were conducted to determine the overall prevalence of depression among farming populations globally, and explore any heterogeneity present. Eligible studies were primary research articles published in English, which involved the collection of data for the purpose of determining the prevalence of depression among a farming population. Four relevant databases were searched in January 2019. Potential for bias was assessed using a modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. From 7662 records, 72 articles were deemed relevant and had data extracted. Of these, 45 utilized the Center for Epidemiologic Studies-Depression Revised scale (CES-D/DR) to quantify depression, 42 of which were conducted in the United States (U.S.). As a result, meta-analyses were restricted to this geographic location. Substantial heterogeneity was seen in the initial whole-group analysis ( = 97%), and while sub-group exploration suggested a significantly higher prevalence of depression among migrant farm workers (26%, 95% CI = 21-31%) than in studies examining a non-migrant farming population (12%, 95% CI = 8-17%), substantial heterogeneity remained ( = 96%), indicating that the majority of between study variation was due to factors other than sampling error. Additionally, the majority of studies (81%) in migrant farm worker populations were published since 2010, while only 21% of studies in non-migrant farming populations were published in this timeframe. It is possible with recent efforts to de-stigmatize mental illness, participants in more recent studies may be more likely to self-report depressive symptoms. Hence, while it appears that migrant farmworker populations may have an elevated prevalence of depression, it is also apparent that little research in the U.S. has been done to evaluate depression among non-migrant farming populations in recent years. Perhaps a reporting bias may account for some of the difference between the two populations. A research gap also appears to exist in estimating the prevalence of depression among farming populations outside of the US. Assessment for bias at the study level revealed challenges in reporting of key study design elements, as well as potential for selection bias in the majority of studies.
进行了系统评价和荟萃分析，以确定全球农业人口中抑郁症的总体患病率，并探讨存在的任何异质性。合格的研究是发表在英语中的主要研究文章，这些文章涉及收集数据以确定农业人口中抑郁症的患病率。2019 年 1 月，四个相关数据库进行了搜索。使用改良的诊断准确性研究质量评估工具（QUADAS）评估偏倚的可能性。从 7662 条记录中，有 72 篇文章被认为是相关的，并提取了数据。其中，45 篇文章使用流行病学研究中心抑郁修订量表（CES-D/DR）来量化抑郁，其中 42 篇文章是在美国进行的。因此，荟萃分析仅限于该地理位置。整个组分析的初始结果显示出很大的异质性（ = 97%），虽然亚组探索表明移民农场工人的抑郁患病率明显高于非移民农业人口（26%，95%CI = 21-31%）（12%，95%CI = 8-17%），但仍存在很大的异质性（ = 96%），表明研究之间的大部分差异不是由于抽样误差引起的。此外，移民农场工人群体中大多数研究（81%）是在 2010 年以后发表的，而在非移民农业人口群体中，只有 21%的研究是在这一时间段内发表的。最近为消除精神疾病污名化所做的努力可能使得最近研究中的参与者更有可能自我报告抑郁症状。因此，尽管移民农场工人群体可能存在更高的抑郁患病率，但近年来，美国对非移民农业人口的抑郁情况进行评估的研究也很少。也许报告偏差可能是这两个群体之间存在差异的部分原因。似乎也存在一个研究空白，即估计美国以外的农业人口中抑郁的患病率。在研究层面上进行的偏倚评估显示，在大多数研究中，关键研究设计元素的报告存在挑战，以及存在选择偏倚的可能性。
