Systematic Review and Meta-analysis of Interventions for Depression and Anxiety in Persons With Rheumatoid Arthritis

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dc.contributor.authorFiest, Kirsten M.
dc.contributor.authorHitchon, Carol A.
dc.contributor.authorBernstein, Charles N.
dc.contributor.authorPeschken, Christine A.
dc.contributor.authorWalker, John R.
dc.contributor.authorGraff, Lesley A.
dc.contributor.authorZarychanski, Ryan
dc.contributor.authorAbou-Setta, Ahmed
dc.contributor.authorPatten, Scott B.
dc.contributor.authorSareen, Jitender
dc.contributor.authorBolton, James
dc.contributor.authorMarrie, Ruth Ann
dc.date.accessioned2019-01-24T21:11:54Z
dc.date.available2019-01-24T21:11:54Z
dc.date.issued2017
dc.descriptionDon Paty Career Development Award from the MS Society of Canada
dc.descriptionBingham Chair in Gastroenterology
dc.descriptionManitoba Research Chair from Research Manitoba
dc.description.abstractBackground Psychiatric comorbidities, such as depression and anxiety, are very common in persons with rheumatoid arthritis (RA) and can lead to adverse outcomes. By appropriately treating these comorbidities, disease-specific outcomes and quality of life may be improved. Objective The aim of this study was to systematically review the literature from controlled trials of treatments for depression and anxiety in persons with RA. Methods We searched multiple online databases from inception until March 25, 2015, without restrictions on language, date, or location of publication. We included controlled trials conducted in persons with RA and depression or anxiety. Two independent reviewers extracted information including trial and participant characteristics. The standardized mean differences (SMDs) of depression or anxiety scores at postassessment were pooled between treatment and comparison groups, stratified by active versus inactive comparators. Results From 1291 unique abstracts, we included 8 RA trials of depression interventions (6 pharmacological, 1 psychological, 1 both). Pharmacological interventions for depression with inactive comparators (n = 3 trials, 143 participants) did not reduce depressive symptoms (SMD, -0.21; 95% confidence interval [CI], -1.27 to 0.85), although interventions with active comparators (n = 3 trials, 190 participants) did improve depressive symptoms (SMD, -0.79; 95% CI, -1.34 to -0.25). The single psychological trial of depression treatment in RA did not improve depressive symptoms (SMD, -0.44; 95% CI, -0.96 to 0.08). Seven of the trials had an unclear risk of bias. Conclusions Few trials examining interventions for depression or anxiety in adults with RA exist, and the level of evidence is low to moderate because of the risk of bias and small number of trials.
dc.description.grantingagencyCanadian Institutes of Health Research
dc.identifier.citationFiest, K. M., Hitchon, C. A., Bernstein, C. N., Peschken, C. A., Walker, J. R., Graff, L. A., … Marrie, R. A. (2017). Systematic Review and Meta-analysis of Interventions for Depression and Anxiety in Persons With Rheumatoid Arthritis. JCR: Journal of Clinical Rheumatology, 23(8), 425–434.https://doi.org/10.1097/rhu.0000000000000489
dc.identifier.doi10.1097/RHU.0000000000000489
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/35778
dc.identifier.issn1076-1608
dc.identifier.other28221313
dc.identifier.urihttp://hdl.handle.net/1880/109519
dc.publisherLIPPINCOTT WILLIAMS & WILKINS
dc.publisher.departmentCritical Care Medicine
dc.publisher.facultyCumming School of Medicine
dc.publisher.hasversionPublished version
dc.publisher.policyhttp://www.wkopenhealth.com/FAQs.html
dc.rightsCopyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
dc.subjectanxiety
dc.subjectdepression
dc.subjectmeta-analysis
dc.subjectrheumatoid arthritis
dc.subjectsystematic review
dc.titleSystematic Review and Meta-analysis of Interventions for Depression and Anxiety in Persons With Rheumatoid Arthritis
dc.typeReview
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