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The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)2136-2148
Number of pages13
JournalRheumatology (Oxford, England)
Issue number12
Early online date3 Sep 2013
E-pub ahead of print3 Sep 2013
PublishedDec 2013


  • Matcham et al. 2013

    Matcham_et_al._2013.pdf, 194 KB, application/pdf

    Uploaded date:10 Apr 2015

    Version:Final published version

King's Authors


Objective. There is substantial uncertainty regarding the prevalence of depression in RA. We conducted a systematic review aiming to describe the prevalence of depression in RA.

Methods. Web of Science, PsycINFO, CINAHL, Embase, Medline and PubMed were searched for cross-sectional studies reporting a prevalence estimate for depression in adult RA patients. Studies were reviewed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and a meta-analysis was performed.

Results. A total of 72 studies, including 13 189 patients, were eligible for inclusion in the review. Forty-three methods of defining depression were reported. Meta-analyses revealed the prevalence of major depressive disorder to be 16.8% (95% CI 10%, 24%). According to the PHQ-9, the prevalence of depression was 38.8% (95% CI 34%, 43%), and prevalence levels according to the HADS with thresholds of 8 and 11 were 34.2% (95% CI 25%, 44%) and 14.8% (95% CI 12%, 18%), respectively. The main influence on depression prevalence was the mean age of the sample.

Conclusion. Depression is highly prevalent in RA and associated with poorer RA outcomes. This suggests that optimal care of RA patients may include the detection and management of depression.

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