Prevalence of Depression in Ankylosing Spondylitis: A Systematic Review and Meta-Analysis

The aim of this study was to provide a summary estimate of depression prevalence among people with ankylosing spondylitis (AS) in comparison to those without AS. A systematic literature search was conducted using PubMed, Embase, PsycINFO, Web of Science, the Cochrane database library, China National Knowledge Infrastructure, and Wanfang Database from their inception to December 2016. The results showed that thirty-one eligible studies involving 8,106 patients were analyzed. Fifteen methods of defining depression were reported. The overall pooled prevalence of depression was 35% (95% CI, 28-43%), with high between-study heterogeneity (I2=98.8%, p<0.001). The relative risk of depression among people with AS was 1.76 (95% CI: 1.21-2.55, eight studies, n=3,006) compared with people without AS. The depression score [standardized mean difference (SMD)=0.43, 95% CI: 0.19-0.67, seven studies, n=549] was higher in AS patients than in controls. The main influence on depression prevalence was the sample size and country of origin. In conclusion, one-third of people with AS experience symptoms of depression. Depression was more prevalent in AS patients than in controls. Further research is needed to identify effective strategies for preventing and treating depression among AS patients.