Prevalence of depression in Systemic sclerosis: A systematic review and meta-analysis

Objective: Systemic sclerosis (SSc) is a connective tissue disease associated with increased functional impairment, body image distress due to skin lesions, and psychosocial comorbidity, particularly depression. However, there is substantial uncertainty concerning the prevalence of depression in SSc. We conducted a systematic review aiming to establish pooled prevalence levels of depression among adult SSc patients. Methods: : We systematically reviewed databases including PubMed, Embase, PsycINFO, and the Cochrane database library from their inception to June 2018. Studies were screened according to inclusion and exclusion criteria and the qualities of included studies were evaluated. The data were analyzed using Stata13 software and the random-effect meta-analysis was conducted on all eligible data. Results: : A total of 30 studies including adult 2239 patients were eligible for inclusion in the systematic review and meta-analysis. The results of meta-analysis revealed that the prevalence of clinically significant depressive symptoms in SSc patients was 41% (95% CI: 34%-48%, P ＜0.01). The depression score in SSc patients (standardized mean difference(SMD) = 0.64, 95% CI: 0.23-1.04, P ＜0.05) was higher than in the control group. Conclusion: Depression is highly prevalent in adult SSc patients and these patients should be carefully monitored and a psychological assistance counselled whenever necessary. Medical staffs should also pay attention to the possible risk factors for depressive symptoms. Trial registration: Current Meta-analysis PROSPERO Registration Number: CRD 42018087380.