Prevalence of depressive symptoms and anxiety in osteoarthritis: a systematic review and meta-analysis

Objective: Osteoarthritis is a leading cause of disability. This systematic review aimed to establish the prevalence of depressive symptoms and anxiety among people with osteoarthritis in comparison to those without osteoarthritis.

Method: We systematically reviewed databases including AMED, EMBASE, MEDLINE, PsycINFO, BNI, CINAHL and the Cochrane database library from their inception to January 2015. Studies presenting data on depressive symptoms and anxiety in people with osteoarthritis were included. A random and fixed-effect meta-analysis was conducted on all eligible data.

Results: A total of 49 studies were included, representing 15,855 individuals (59% women; mean age 65.2 years). The evidence-base was moderate in quality. The pooled prevalence of depressive symptoms in osteoarthritis was 19.9% (95% Confidence Intervals (CI): 15.9% to 24.5%, n=10,811). The corresponding pooled prevalence was 21.3% (95% CI: 15.5% to 28.5%; n=1,226) for anxiety symptoms. The relative risk of depression among people with osteoarthritis was 1.17 (95% CI 0.69 to 2.00, 3 studies, n=941) compared to people without osteoarthritis. The relative risk of anxiety was 1.35 (95% CI: 0.51 to 3.59; 3 studies, n=733) compared to those without osteoarthritis.

Conclusion: One fifth of people with osteoarthritis experience symptoms of depression and anxiety. However it is uncertain whether this is increased compared to those without osteoarthritis, with no direct evidence to support an increase in anxiety and depression in osteoarthritis.