Meta-analysis: 1 in 4 fibromyalgia patients have depression

  • Løge-Hagen JS & al.
  • J Affect Disord
  • 15 Feb 2019

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • A meta-analysis finds that the point prevalence of comorbid major depressive disorder (MDD) is 25% in patients with fibromyalgia (FM), using structured clinical interviews (SCI), the diagnostic gold standard.
  • Lifetime prevalence of comorbid MDD is 65%.
  • Calculating prevalence using patient-administered methods likely yields an overestimate of MDD comorbidity.

Why this matters

  • Depression should be routinely screened for in all FM cases, using clinician-administered SCI or screening symptom scales (SSS).

Study design

  • Meta-analysis of 11 studies (n>1000) after search of MEDLINE, EMBASE, CENTRAL, and PsychINFO.
  • Inconsistency was assessed by heterogeneity.
  • Funding: None.

Key results

  • Using clinician-administered SCI:
    • Pooled point prevalence of MDD was 25% (95% CI, 19%-31%).
    • Pooled lifetime prevalence of MDD was 65% (95% CI, 59%-71%).
  • Clinician-administered SSS:
    • Pooled point prevalence of MDD was 23% (95% CI, 10%-41%).
  • Patient-administered SSS:
    • Pooled point prevalence was 45% (95% CI, 32%-59%).
  • Low inconsistency was seen for clinician-administered point prevalence (I2=42.36%), and no inconsistency for clinician-administered lifetime prevalence (I2=0.00%); high inconsistency was seen for the patient-administered point prevalence (I2=92.13%).

Limitations

  • Classification of MDD and FM varied across studies.

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