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Meta-Analysis
. 2019 Dec;9(2):020417.
doi: 10.7189/jogh.09.020417.

A systematic review and meta-analysis of the prevalence of common mental disorders in people with non-communicable diseases in Bangladesh, India, and Pakistan

Eleonora P Uphoff  1 , Louise Newbould  2 , Ian Walker  2   3 , Nabila Ashraf  4 , Santosh Chaturvedi  5 , Arun Kandasamy  6 , Papiya Mazumdar  2 , Nick Meader  7 , Aliya Naheed  4 , Rusham Rana  8 , Jerome Wright  2 , Judy M Wright  9 , Najma Siddiqi  2   10 , Rachel Churchill  1   10 ; NIHR Global Health Research Group – IMPACT
Affiliations
Meta-Analysis

A systematic review and meta-analysis of the prevalence of common mental disorders in people with non-communicable diseases in Bangladesh, India, and Pakistan

Eleonora P Uphoff et al. J Glob Health. 2019 Dec.

Abstract

Background: The prevalence of mental and physical comorbidities is unknown in South Asia, as estimates of mental ill health in patients with non-communicable diseases (NCDs) have predominantly come from studies based in the United States, Europe and Australasia. This systematic review and meta-analysis summarises evidence and provides pooled estimates of the prevalence of common mental disorders in adults with non-communicable diseases in South Asia.

Methods: We included prevalence studies of depression and anxiety in adults with diabetes, cancer, cardiovascular disease, and chronic respiratory conditions in Bangladesh, India, and Pakistan, published from 1990 onwards in international and country-specific databases.

Results: Out of 96 included studies, 83 provided data for random effects meta-analyses. The pooled prevalence of depression was 44% (95% confidence interval (CI) = 26 to 62) for patients with COPD, 40% (95% CI = 34 to 45) for diabetes, 39% (95% CI = 23 to 56) for stroke, 38% (95% CI = 32 to 45) for hypertension, and 37% (95% CI = 30 to 45) for cancer. The pooled prevalence of anxiety based on 28 studies was 29% (95% CI = 22 to 36). Many quality issues were identified in a critical appraisal of included studies, mostly relating to the sampling frame and selection process, the description of the methods and basic data, and the description of non-responders.

Conclusions: Depression and anxiety are prevalent and underdiagnosed in people with physical comorbidities in Bangladesh, India, and Pakistan.

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Conflict of interest statement

Competing interests: The authors completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available upon request from the corresponding author), and declare no conflicts of interest.

Figures

Figure 1
Figure 1
Study selection process. CMD – common mental disorders, NCD – non-communicable disease.
Figure 2
Figure 2
Summary of quality assessment. Green: high quality. Orange: unclear quality. Red: low quality.
Figure 3
Figure 3
Meta-analysis of the prevalence of depression in patients with diabetes. CMD – common mental disorders, NCD – non-communicable disease. *Three estimates are included for Lloyd et al 2018 for data from Bangladesh, India, and Pakistan.
Figure 4
Figure 4
Meta-analysis of the prevalence of depression in patients with cancer CMD – common mental disorders, NCD – non-communicable disease.
Figure 5
Figure 5
Meta-analysis of the prevalence of depression in patients with COPD CMD – common mental disorders, NCD – non-communicable disease, COPD – chronic obstructive pulmonary disease.
See this image and copyright information in PMC

References

    1. World Health Organization. Depression and other Common Mental Disorders. Global Health Estimates. World Health Organization, 2017. Available: https://www.who.int/mental_health/management/depression/prevalence_globa.... Accessed: 8 December 2018.
    1. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: A systematic analysis for the global burden of disease study 2017. Lancet. 2018;392:1789-858. 10.1016/S0140-6736(18)32279-7 - DOI - PMC - PubMed
    1. Scott KM, Bruffaerts R, Tsang A, Ormel J, Alonso J, Angermeyer MC, et al. Depression–anxiety relationships with chronic physical conditions: Results from the World Mental Health surveys. J Affect Disord. 2007;103:113-20. 10.1016/j.jad.2007.01.015 - DOI - PubMed
    1. Wainberg ML, Scorza P, Shultz JM, Helpman L, Mootz JJ, Johnson KA, et al. Challenges and Opportunities in Global Mental Health: a Research-to-Practice Perspective. Curr Psychiatry Rep. 2017;19:28. 10.1007/s11920-017-0780-z - DOI - PMC - PubMed
    1. World Health Organization. Management of physical health conditions in adults with severe mental disorders. World Health Organization, 2018. Available: http://apps.who.int/iris/bitstream/handle/10665/275718/9789241550383-eng.... Accessed: 20 December 2018. - PubMed