There is an increased prevalence of depression in patients with degenerative spine disease (DSD) and, considering the relationship between depression and poor surgical outcomes, more attention should be paid to identifying strategies for preventing and treating depression in DSD patients. This is according to a new study published recently in the European Spine Journal.
The study, conducted by Xiang Zhou (West China Hospital, Chengdu, China) et al, was designed to estimate the prevalence of depression in DSD patients.
The PubMed, EMBASE, and PsycINFO databases were systematically searched, and the relevant studies that reported the depression prevalence of in DSD patients identified. Data were extracted independently by two reviewers and a subgroup analysis and sensitivity analysis were also performed.
A total of 24 articles met the inclusion criteria. The pooled prevalence estimate of depression in DSD patients before operative treatment was 30.8% [95% CI 24.0–38.5%]. Nine articles reported the prevalence rate in DSD patients after operative treatment, and the pooled prevalence estimate was 27.0% [95% CI 19.9–35.4%].
There were significant differences for prevalence estimates before operative treatment in types of disorders (Q = 4.56, P= 0.10), spine surgery history (Q = 5.55, P= 0.02), representativeness of sample (Q = 11.00, P= 0), and validity of assessment method (Q = 3.32, P =0.07).
The prevalence estimates in patients with lumbar spine stenosis, lumbar disc herniation and cervical spondylotic myelopathy were 24.0%, 40.9% and 37.3%, respectively.
Studies that included patients with a history of spine surgery yielded a more extreme prevalence estimate than studies excluding those (36.9% vs 24.3%).
For results of patients after operative treatment, significant differences for prevalence estimates were shown in different degrees of pain (Q = 4.72, P= 0.03), screening instruments (Q = 4.83, P= 0.09), and representativeness of sample (Q = 15.70, P =0).