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Research article
The incidence of depression and anxiety in patients with ankylosing spondylitis: A systematic review and meta-analysis
Mary A De Vera
University of British Columbia
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2205-2683
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This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Rheumatology.
Background: As awareness for the importance of mental health continues to expand in rheumatology, it is important to understand the epidemiology of psychiatric complications in ankylosing spondylitis (AS) with the ultimate goal of future prevention and improved quality of care. This study aims to review evidence on the incidence and determinants of depression and/or anxiety among patients with AS. Methods: We searched Medline, Embase, Cochrane Database of Systematic Reviews, CINAHL Complete, and PsycINFO for full-length observational studies that involved a sample or population of patients with AS and assessed depression and/or anxiety. Primary outcomes extracted were: 1) risk estimates for depression and/or anxiety (e.g., relative risk [RR]); and 2) determinants or factors identified as independent predictors of depression and/or anxiety using multivariable regression approaches and corresponding estimates (e.g., odds ratios [OR]). Where relevant, we pooled estimates using random effects models. Results: Out of 783 titles from our search strategy, we reviewed 39 manuscripts. Four studies assessed the incidence of depression and meta-analyzing reported estimates from three of these studies yielded a pooled RR of 1.51 (95% CI 1.28 to 1.79). Differences in risk of depression among men and women with AS were inconclusive, suggesting need for further study. The incidence of anxiety was comparatively less studied with only one included study reporting a hazard ratio of 1.85 (95% CI 1.37 to 2.49). Education level was a key determinant, with lower levels associated with higher odds of depression (OR 6.65; 9% CI 1.36 to 32.51) and anxiety (OR 9.31; 9% CI 1.39 to 62.19) among AS patients. Conclusions: Our systematic review and meta-analysis shows an increased risk of depression and anxiety among patients with AS. These findings suggest the importance of monitoring and care for psychiatric conditions in AS.
Keywords
ankylosing spondylitis, depression, anxiety, mental health, systematic review, meta-analysis
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CURRENT STATUS: Published
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Posted 03 Jan, 2020
Published
On 02 Mar, 2020
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Editorial decision: Accept
On 30 Dec, 2019
Editor assigned
On 27 Dec, 2019
Submission checks complete
On 26 Dec, 2019
Editor invited
On 26 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 23 Dec, 2019
Review #2 received
Received 22 Dec, 2019
Review #1 received
Received 08 Dec, 2019
Reviewer #3 agreed
On 01 Dec, 2019
Reviewer #2 agreed
On 29 Nov, 2019
Editor assigned
On 28 Nov, 2019
Reviewers invited
Invitations sent on 28 Nov, 2019
Reviewer #1 agreed
On 28 Nov, 2019
Submission checks complete
On 21 Nov, 2019
Editor invited
On 20 Nov, 2019
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This preprint is under consideration at BMC Rheumatology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
The incidence of depression and anxiety in patients with ankylosing spondylitis: A systematic review and meta-analysis
Mary A De Vera
University of British Columbia
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2205-2683
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 03 Jan, 2020
Published
On 02 Mar, 2020
No community comments so far
Editorial decision: Accept
On 30 Dec, 2019
Editor assigned
On 27 Dec, 2019
Submission checks complete
On 26 Dec, 2019
Editor invited
On 26 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 23 Dec, 2019
Review #2 received
Received 22 Dec, 2019
Review #1 received
Received 08 Dec, 2019
Reviewer #3 agreed
On 01 Dec, 2019
Reviewer #2 agreed
On 29 Nov, 2019
Editor assigned
On 28 Nov, 2019
Reviewers invited
Invitations sent on 28 Nov, 2019
Reviewer #1 agreed
On 28 Nov, 2019
Submission checks complete
On 21 Nov, 2019
Editor invited
On 20 Nov, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Rheumatology.
Background: As awareness for the importance of mental health continues to expand in rheumatology, it is important to understand the epidemiology of psychiatric complications in ankylosing spondylitis (AS) with the ultimate goal of future prevention and improved quality of care. This study aims to review evidence on the incidence and determinants of depression and/or anxiety among patients with AS. Methods: We searched Medline, Embase, Cochrane Database of Systematic Reviews, CINAHL Complete, and PsycINFO for full-length observational studies that involved a sample or population of patients with AS and assessed depression and/or anxiety. Primary outcomes extracted were: 1) risk estimates for depression and/or anxiety (e.g., relative risk [RR]); and 2) determinants or factors identified as independent predictors of depression and/or anxiety using multivariable regression approaches and corresponding estimates (e.g., odds ratios [OR]). Where relevant, we pooled estimates using random effects models. Results: Out of 783 titles from our search strategy, we reviewed 39 manuscripts. Four studies assessed the incidence of depression and meta-analyzing reported estimates from three of these studies yielded a pooled RR of 1.51 (95% CI 1.28 to 1.79). Differences in risk of depression among men and women with AS were inconclusive, suggesting need for further study. The incidence of anxiety was comparatively less studied with only one included study reporting a hazard ratio of 1.85 (95% CI 1.37 to 2.49). Education level was a key determinant, with lower levels associated with higher odds of depression (OR 6.65; 9% CI 1.36 to 32.51) and anxiety (OR 9.31; 9% CI 1.39 to 62.19) among AS patients. Conclusions: Our systematic review and meta-analysis shows an increased risk of depression and anxiety among patients with AS. These findings suggest the importance of monitoring and care for psychiatric conditions in AS.
Figure 1
Figure 2