title: Prevalence of depressive symptoms and anxiety in osteoarthritis: a systematic review and meta-analysis.
abstract: 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.
  
  
  METHODS
  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): 15.9-24.5%, n = 10,811). The corresponding pooled prevalence was 21.3% (95% CI: 15.5-28.5%; n = 1,226) for anxiety symptoms. The relative risk of depression among people with osteoarthritis was 1.17 (95% CI 0.69-2.00, three studies, n = 941) compared with people without osteoarthritis. The relative risk of anxiety was 1.35 (95% CI: 0.51-3.59; three studies, n = 733) compared with those without osteoarthritis.
  
  
  CONCLUSIONS
  one-fifth of people with osteoarthritis experience symptoms of depression and anxiety. However, it is uncertain whether this is increased compared with those without osteoarthritis, with no direct evidence to support an increase in anxiety and depression in osteoarthritis.
  CRD42013006733.
authors.affiliation: University of Greenwich, London, UK.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
authors.affiliation: University of Aberdeen, Aberdeen, UK.
authors.forename: Yetty
authors.initials: Y
authors.lastname: Aluko
authors.affiliation: School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK Clinical Gerontology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, Cambridgeshire, UK.
authors.forename: Phyo Kyaw
authors.initials: PK
authors.lastname: Myint
authors.affiliation: Faculty of Medicine and Health Sciences, Norwich, Norfolk, UK.
authors.forename: Toby O
authors.initials: TO
authors.lastname: Smith
mesh_terms: D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010003:Osteoarthritis / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors
keywords: degenerative; mood; older people; osteoarthritis; pain; psychological; systematic review