Nouri Elham, Moradi Yousef, Moradi Ghobad
Social Determinant of the Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Ann Gen Psychiatry. 2022 Sep 12;21(1):38. doi: 10.1186/s12991-022-00414-1.
Depression due to stigma resulting from their sexual identity, isolation, social exclusion, and insufficient access to care and counseling services has become a health problem among men who have sex with men (MSM).
This study aimed to determine the global prevalence of depression among MSM as a systematic review and meta-analysis.
This study was a systematic review and meta-analysis performed in five steps of search strategy, screening and selecting articles, data extraction, evaluation of the risk of bias, and meta-analysis. In this study, the determined keywords were searched in the databases of PubMed, Scopus, Embase, and Web of Science from January 1913 to July 2021 to find the initial articles, from which data were extracted according to the set checklist in the data extraction stage. Finally, the studies were included in the present meta-analysis according to the inclusion and exclusion criteria, to be evaluated using the Newcastle Ottawa scale checklist. I Square and Q Cochrane were also used to assess the degree of heterogeneity. The analyses were performed using the random-effects model in STATA 16.
The results showed the quality score of the majority of cross-sectional studies included in the meta-analysis (62 studies) was equal to six or seven (moderate), and five ones had a high-quality score. After combining these studies, the pooled prevalence of depression among MSM in the world was 35% (95% CI 31%-39%, I square; 98.95%, P-value < 0.001). Population subgroup analysis showed the pooled prevalence of depression among MSM living with HIV was 47% (95% CI 39%-55%, I square; 95.76%, P-value < 0.001). Continent subgroup analysis showed the highest pooled prevalence of depression among Asian MSM at 37% (95% CI 31%-43%, I square; 99.07%, P-value < 0.001). Also, in the subgroup analysis of the sampling method, the pooled prevalence in the studies which used the respondent-driven sampling method was equal to 34% (95% CI 25%-43%, I square; 99.32%, P-value < 0.001). Sensitivity analysis revealed the pooled prevalence of depression in studies included in the meta-analysis was near or around the pooled estimate.
The pooled prevalence of depression among MSM was almost three times higher than the general male population. Therefore, particular and therapeutic interventions such as screening, and harm reduction programs for mental disorders, especially depression, are suggested to be considered in service packages.
由于性取向带来的耻辱感、孤立、社会排斥以及获得护理和咨询服务的机会不足，导致与男性发生性关系者（MSM）中出现抑郁症，这已成为一个健康问题。
本研究旨在通过系统评价和荟萃分析确定MSM中抑郁症的全球患病率。
本研究是一项系统评价和荟萃分析，分五步进行，包括检索策略、筛选和选择文章、数据提取、偏倚风险评估以及荟萃分析。在本研究中，从1913年1月至2021年7月在PubMed、Scopus、Embase和Web of Science数据库中搜索确定的关键词，以找到初始文章，并在数据提取阶段根据设定的清单从中提取数据。最后，根据纳入和排除标准将这些研究纳入本荟萃分析，使用纽卡斯尔渥太华量表清单进行评估。还使用I方和Q Cochr ane评估异质性程度。使用STATA 16中的随机效应模型进行分析。
结果显示，纳入荟萃分析的大多数横断面研究（62项研究）的质量得分等于6或7（中等），5项研究质量得分高。合并这些研究后，全球MSM中抑郁症的合并患病率为35%（95%CI 31%-39%，I方；98.95%，P值<0.001）。人群亚组分析显示，感染艾滋病毒的MSM中抑郁症的合并患病率为47%（95%CI 39%-55%，I方；95.76%，P值<0.001）。大陆亚组分析显示，亚洲MSM中抑郁症的合并患病率最高，为37%（95%CI 31%-43%，I方；99.07%，P值<0.001）。此外，在抽样方法的亚组分析中，使用应答者驱动抽样方法的研究中的合并患病率等于34%（95%CI 25%-43%，I方；99.32%，P值<0.001）。敏感性分析显示，荟萃分析中纳入研究中抑郁症的合并患病率接近或围绕合并估计值。
MSM中抑郁症的合并患病率几乎是一般男性人群的三倍。因此，建议在服务套餐中考虑特殊的治疗性干预措施，如筛查以及针对精神障碍尤其是抑郁症的减少伤害项目。
