Prevalence of depression among Iranian patients with rheumatoid arthritis: a systematic review and meta-analysis

Abstract

Tayebeh Jamshidi,1 Reza Ghanei Gheshlagh,2,3 Fariba Ebtekar,4 Sahar Dalvand,5 Amir Vahedian Azimi,6 Amanj Kurdi7 1Psychiatric Nursing Department, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Clinical Care Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran; 3Department of Nursing, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran; 4Department of Midwifery, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran; 5Department of epidemiology and Biostatistics, school of Public health, Tehran University of Medical sciences, Tehran, Iran; 6Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran; 7Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, UK Abstract: Patients with rheumatoid arthritis (RA) are prone to depression due to several factors related to their RA, including chronic and persistent pain, functional disability, economic constraints, and the side effects of RA medication. Previous Iranian studies showed conflicting and inconclusive findings regarding the prevalence of depression among RA patients. Therefore, this systematic review and meta-analysis was conducted to estimate the true prevalence of depression in Iranian patients with RA. Search for eligible articles was performed using the keywords of depression, depressive disorder, dysthymic disorder, major depressive disorder, RA, and Iran, and their possible combinations in the following databases: Scientific Information Database, MagIran, Web of Science/ISI, PubMed, and Scopus. The search was restricted to articles published in Persian and English languages. The meta-analysis was performed using the random effects model, and the data were analyzed using the STATA software version 12. Overall, six articles were selected; the overall prevalence of depression among the Iranian patients with RA was 65.58% (95% CI: 56.53%–74.62%). There were no significant relationships between the prevalence of depression and articles’ methodological quality and year of publication, participants’ age, sample size, and duration of disease. More than half of RA patients suffer from depression. The overlap between the physical symptoms of RA and depression in this group of patients makes it difficult to correctly diagnose depression; therefore, initiative and efforts are required to improve the identification of early depression symptoms in RA patients in order to effectively manage their depression. Keywords: depression, Iran, meta-analysis, prevalence, rheumatoid arthritis

Keywords

• Depression
• Iran
• Meta-analysis
• Prevalence
• Rheumatoid arthritis.