The prevalence and impact of depression in primary systemic vasculitis: a systematic review and meta-analysis

Abstract

Objective To describe the prevalence of depression among patients with primary systemic vasculitides (PSV); compare prevalence according to vasculitis type and against controls; and examine the impact of depression on PSV outcomes. Methods We searched Medline, PubMed, Scopus and Web of Science using a predefined protocol in accordance with PRISMA guidelines. We included all studies that reported the prevalence or impact of depression in PSV. We also included polymyalgia rheumatica (PMR) given its association with giant cell arteritis (GCA). Meta-analyses of prevalence estimates were performed using random-effects models and reported as percentages (95% confidence interval). Results We reviewed a total of 15 studies that described the prevalence of depression, categorised into small (n = 10) and large vessel vasculitis (n = 7). Pooled prevalence estimate for depression in a small vessel (predominantly ANCA-associated) vasculitis was 28% (95% CI 20-38%) with significant heterogeneity (I 2 = 93%). Depression prevalence in large-vessel vasculitis (Takayasu and GCA/PMR) was 24% (95% CI 17-34%), again with significant heterogeneity (I 2 = 96%). One study reported 56% prevalence of depression in medium vessel disease. The prevalence of depression in small vessel vasculitis was higher than healthy controls. In these patients, depression and depressive symptoms were associated with poorer quality of life, adherence, and work disability, but not disease activity or damage. Conclusion Depression is highly prevalent among patients with primary systemic vasculitis and associated with poorer outcomes across a range of measures in studies of small vessel disease. Further studies are needed for depression in medium and large vessel vasculitides.

Patient-Reported Outcome Measures in Takayasu Arteritis: A Systematic Review and Meta-Analysis

“…Searches were analyzed in duplicate by two investigators (DPM, PP); any disagreements were resolved by mutual discussion. Additional studies were included based on prior knowledge or screening reference lists of previous reviews [ 24 ]. The search results are shown in ESM Fig.…”

Anxiety and depression in patients with giant cell arteritis

“…Depression is known to negatively impact QOL, treatment adherence and mortality [ 5 , 6 ]. Higher rates of depression have been previously reported in patients with primary systemic vasculitis compared with RA, PsA and AS [ 7 ]. A few studies have specifically explored the occurrence of depression in GCA but relied on self-reporting or inadequately validated measuring tools [ 8–10 ].…”

Psychological Assessment and Behavioural Interventions in a Young Girl with Antineutrophil Cytoplasmic Antibody-associated Vasculitis

“…ANCA-associated vasculitis may have a great psychosocial impact due to poor peer relationships, adjustment disorder, 3 anxiety, depression, 4 changes in lifestyle and poor quality of life. 5 The index patient had average intellectual abilities with several behavioural issues.…”

“…Similar findings have been reported in adults. 4 ANCA vasculitis also affects physical functioning in terms of easy fatigability and social functioning. 5 She had low self-esteem and scored low on physical appearance, anxiety and happiness sub-scales of children's self-concept scale.…”

“…Similar findings have been reported in adults. 4 ANCA vasculitis also affects physical functioning in terms of easy fatigability and social functioning. 5…”