Depression and Anxiety Trajectories in Chronic Disease: A Systematic Review and Meta-Analysis.

IF 16.3 1区 医学 Q1 PSYCHIATRY Psychotherapy and Psychosomatics Pub Date : 2023-01-01 Epub Date: 2023-08-22 DOI:10.1159/000533263
Amelia J Scott, Ashleigh B Correa, Madelyne A Bisby, Blake F Dear
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Abstract

Introduction: People living with chronic diseases are at an increased risk of anxiety and depression, which are associated with poorer medical and psychosocial outcomes. Many studies have examined the trajectories of depression and anxiety in people with specific diseases, including the predictors of these trajectories. This is valuable for understanding the process of adjustment to diseases and informing treatment planning. However, no review has yet synthesised this information across chronic diseases.

Methods: Electronic databases were searched for studies reporting trajectories of depression or anxiety in chronic disease samples. Data extracted included sample characteristics, results from trajectory analyses, and predictors of trajectories. Meta-analysis of the overall pooled prevalence of depression and anxiety trajectories was conducted, and qualitative synthesis of disease severity predictors was undertaken.

Results: Following search and screening, 67 studies were included (N = 61,201 participants). Most participants followed a stable nonclinical trajectory for depression (69.0% [95% CI: 65.6, 72.2]) and anxiety (73.4% [95% CI: 66.3, 79.5]). Smaller but meaningful subsamples followed a trajectory of depression and anxiety symptoms consistently in the clinical range (11.8% [95% CI: 9.2, 14.8] and 13.7% [95% CI: 9.3, 19.7], respectively). Several clinical and methodological moderators emerged, and qualitative synthesis suggested that few aspects of disease severity were associated with participants' trajectories.

Conclusion: Most people with chronic disease follow a trajectory of distress that is low and stable, suggesting that most people psychologically adjust to living with chronic disease. Evidence also suggests that the nature and severity of the disease are not meaningful predictors of psychological distress.

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慢性病患者的抑郁和焦虑轨迹:系统综述和荟萃分析。
引言:患有慢性病的人患焦虑和抑郁的风险增加,这与较差的医疗和心理社会结果有关。许多研究已经检查了患有特定疾病的人的抑郁和焦虑的轨迹,包括这些轨迹的预测因素。这对于理解疾病的适应过程和为治疗计划提供信息是很有价值的。然而,还没有任何综述综合了慢性病的这些信息。方法:在电子数据库中搜索报告慢性病样本中抑郁或焦虑轨迹的研究。提取的数据包括样本特征、轨迹分析结果和轨迹预测因素。对抑郁和焦虑轨迹的总体合并患病率进行了荟萃分析,并对疾病严重程度预测因素进行了定性综合。结果:经过搜索和筛选,纳入了67项研究(N=61201名参与者)。大多数参与者在抑郁(69.0%[95%CI:65.6,72.2])和焦虑(73.4%[95%CI=66.3,79.5])方面遵循稳定的非临床轨迹。较小但有意义的子样本在临床范围内始终遵循抑郁和焦虑症状的轨迹(分别为11.8%[95%CI:9.2,14.8]和13.7%[95%CI:9.3,19.7])。出现了几个临床和方法论调节因子,定性综合表明,疾病严重程度的几个方面与参与者的轨迹有关。结论:大多数慢性病患者的痛苦轨迹是低而稳定的,这表明大多数人在心理上适应了慢性病的生活。证据还表明,疾病的性质和严重程度并不是心理困扰的有意义的预测因素。
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来源期刊
Psychotherapy and Psychosomatics
Psychotherapy and Psychosomatics 医学-精神病学
CiteScore
29.40
自引率
6.10%
发文量
46
期刊介绍: Psychotherapy and Psychosomatics is a reputable journal that has been published since 1953. Over the years, it has gained recognition for its independence, originality, and methodological rigor. The journal has been at the forefront of research in psychosomatic medicine, psychotherapy research, and psychopharmacology, and has contributed to the development of new lines of research in these areas. It is now ranked among the world's most cited journals in the field. As the official journal of the International College of Psychosomatic Medicine and the World Federation for Psychotherapy, Psychotherapy and Psychosomatics serves as a platform for discussing current and controversial issues and showcasing innovations in assessment and treatment. It offers a unique forum for cutting-edge thinking at the intersection of medical and behavioral sciences, catering to both practicing clinicians and researchers. The journal is indexed in various databases and platforms such as PubMed, MEDLINE, Web of Science, Science Citation Index, Social Sciences Citation Index, Science Citation Index Expanded, BIOSIS Previews, Google Scholar, Academic Search, and Health Research Premium Collection, among others.
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