Prevalence of comorbid depression in schizophrenia: A meta-analysis of observational studies

Wen Li; Yuan Yang; Feng-Rong An; Ling Zhang; Gabor S Ungvari; Todd Jackson; Zhen Yuan; Yu-Tao Xiang

doi:10.1016/j.jad.2020.04.056

Prevalence of comorbid depression in schizophrenia: A meta-analysis of observational studies

J Affect Disord. 2020 Aug 1:273:524-531. doi: 10.1016/j.jad.2020.04.056. Epub 2020 May 12.

Authors

Wen Li¹, Yuan Yang², Feng-Rong An³, Ling Zhang³, Gabor S Ungvari⁴, Todd Jackson⁵, Zhen Yuan¹, Yu-Tao Xiang⁶

Affiliations

¹ Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China.
² Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China; Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangdong, China.
³ The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
⁴ University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia.
⁵ Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, SAR, China.
⁶ Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China. Electronic address: xyutly@gmail.com.

PMID: 32560949
DOI: 10.1016/j.jad.2020.04.056

Abstract

Introduction: Comorbid depressive symptoms (depression thereafter) often occur in schizophrenia and are associated with negative outcomes. This meta-analysis estimated the prevalence of comorbid depression and its associated factors in schizophrenia.

Methods: Both international (PubMed, EMBASE, PsycINFO, and Web of Science) and Chinese (WANFANG and CNKI) databases were systematically searched. Studies with data on the prevalence of comorbid depression in schizophrenia measured with the Calgary Depression Scale for Schizophrenia (CDSS) were included. Random-effects models were used in all analyses.

Results: Fifty-three studies covering 9,879 patients were included. The pooled prevalence of comorbid depression was 28.6% (95%CI: 25.3%-32.2%). Subgroup analyses revealed that studies examining inpatients, being published in Chinese language, or those with lower CDSS cut-od values reported higher depression rates. Meta-regression analyses indicated that the rate of depression was positively associated with publication year, proportion of males, mean age, and severity of psychotic symptoms, and negatively associated with illness duration and study quality.

Conclusion: Comorbid depression is common in schizophrenia. Due to its negative impact on patients' quality of life and prognosis, regular screening and effective treatment for comorbid depression should be implemented in patients with schizophrenia.

Keywords: Depression; Meta-analysis; Prevalence; Schizophrenia.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Depression / epidemiology
Humans
Male
Mass Screening
Prevalence
Quality of Life
Schizophrenia* / epidemiology