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Review
. 2019:41:e2019030.
doi: 10.4178/epih.e2019030. Epub 2019 Jul 4.

Meta-analysis of the prevalence of depression among breast cancer survivors in Iran: an urgent need for community supportive care programs

Hassan Ahmadi Gharaei  1 , Mostafa Dianatinasab  2 , Seyyed Mostafa Kouhestani  3 , Mohammad Fararouei  4 , Hossein Moameri  1 , Reza Pakzad  5   6 , Reza Ghaiasvand  7
Affiliations
Review

Meta-analysis of the prevalence of depression among breast cancer survivors in Iran: an urgent need for community supportive care programs

Hassan Ahmadi Gharaei et al. Epidemiol Health. 2019.

Abstract

Objectives: Depression, which is the most common comorbidity in breast cancer (BC) patients, has adverse effects on patients' quality of life, disease progress, and survival.

Methods: The protocol of this study was registered in PROSPERO (registration No. CRD42019121494). We electronically searched published studies through January 2019 with the aim of finding articles that investigated the prevalence of depression among BC survivors. Web of Science, Scopus, PubMed/MEDLINE, Science Direct, and Google Scholar were searched to obtain relevant published studies. This review included 14 cross-sectional and 4 cohort studies published from 2000 to 2018. We used a random-effects model to conduct the meta-analysis and generated a summary estimate for the pooled prevalence with 95% confidence intervals (CIs). A subgroup analysis was also conducted based on the depression assessment tool used and the study design.

Results: The total sample size of the studies contained 2,799 women with BC, including 1,228 women who were diagnosed with depression. The pooled prevalence of depression among Iranian women with BC was 46.83% (95% CI, 33.77 to 59.88) with significant heterogeneity (I2 =98.5%; p<0.001). The prevalence of depression ranged from 14.00% (95% CI, 4.91 to 23.09) to 95.90% (95% CI, 91.97 to 99.83). The results of the subgroup analyses suggested that the depression assessment tool, year of publication, and study design were sources of heterogeneity.

Conclusions: Our findings indicate a high prevalence of depression among BC patients, underscoring the urgent need for clinicians and health authorities to provide well-defined social and psychological supportive care programs for these patients.

Keywords: Breast carcinoma; Depression; Meta-analysis; Prevalence; Quality of life; Supportive care.

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Conflict of interest statement

The authors have no conflicts of interest to declare for this study.

Figures

Figure 1.
Figure 1.
Flowchart of study inclusion and exclusion according to the PRISMA (Preferred Reporting Items for Systematic Reviews and MetaAnalyses) statement.
Figure 2.
Figure 2.
Forest plot of all 18 studies included in the meta-analysis based on the depression assessment tool used. ES, effect size (prevalence); CI, confidence interval; BDI, Beck Depression Inventory; HADS, Hospital Anxiety and Depression Scale.
Figure 3.
Figure 3.
Prevalence of depression among Iranian breast cancer, showing an increase in prevalence from 2000 to 2018.
Figure 4.
Figure 4.
Prevalence of depression among Iranian breast cancer patients based on the year of publication. ES, effect size (prevalence); CI, confidence interval.
Figure 5.
Figure 5.
Funnel plot of the studies included in the meta-analysis.
Figure 6.
Figure 6.
Forest plot of all studies based on study design. ES, effect size (prevalence); CI, confidence interval.
See this image and copyright information in PMC

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