As awareness for the importance of mental health continues to expand in rheumatology, it is important to understand the epidemiology of psychiatric complications in ankylosing spondylitis (AS) with the ultimate goal of future prevention and improved quality of care. This study aims to review evidence on the incidence and determinants of depression and/or anxiety among patients with AS. We searched Medline, Embase, Cochrane Database of Systematic Reviews, CINAHL Complete, and PsycINFO for full-length observational studies that involved a sample or population of patients with AS and assessed depression and/or anxiety. Primary outcomes extracted were: 1) risk estimates for depression and/or anxiety (e.g., relative risk [RR]); and 2) determinants or factors identified as independent predictors of depression and/or anxiety using multivariable regression approaches and corresponding estimates (e.g., odds ratios [OR]). Where relevant, we pooled estimates using random effects models. Out of 783 titles from our search strategy, we reviewed 39 manuscripts. Four studies assessed the incidence of depression and meta-analyzing reported estimates from three of these studies yielded a pooled RR of 1.51 (95% CI 1.28 to 1.79). Differences in risk of depression among men and women with AS were inconclusive, suggesting need for further study. The incidence of anxiety was comparatively less studied with only one included study reporting a hazard ratio of 1.85 (95% CI 1.37 to 2.49). Education level was a key determinant, with lower levels associated with higher odds of depression (OR 6.65; 9% CI 1.36 to 32.51) and anxiety (OR 9.31; 9% CI 1.39 to 62.19) among AS patients. Our systematic review and meta-analysis shows an increased risk of depression and anxiety among patients with AS. These findings suggest the importance of monitoring and care for psychiatric conditions in AS.

中文翻译：

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强直性脊柱炎患者抑郁和焦虑的发生率：系统评价和荟萃分析

随着对精神健康重要性的认识在风湿病学中的不断扩大，了解强直性脊柱炎 (AS) 中精神并发症的流行病学非常重要，其最终目标是未来预防和提高护理质量。本研究旨在回顾关于 AS 患者抑郁和/或焦虑的发生率和决定因素的证据。我们检索了 Medline、Embase、Cochrane 系统评价数据库、CINAHL Complete 和 PsycINFO，以获取涉及 AS 患者样本或人群并评估抑郁和/或焦虑的完整观察性研究。提取的主要结果是：1）抑郁和/或焦虑的风险估计（例如，相对风险[RR]）；2) 使用多变量回归方法和相应的估计值（例如，优势比 [OR]）确定为抑郁和/或焦虑的独立预测因素的决定因素或因素。在相关的情况下，我们使用随机效应模型汇总估计。在我们搜索策略的 783 个标题中，我们审阅了 39 篇手稿。四项研究评估了抑郁症的发病率，对其中三项研究报告的估计值进行荟萃分析得出的汇总 RR 为 1.51（95% CI 1.28 至 1.79）。AS 男性和女性患抑郁症的风险差异尚无定论，表明需要进一步研究。对焦虑发生率的研究相对较少，只有一项纳入研究报告的风险比为 1.85（95% CI 1.37 至 2.49）。教育水平是一个关键的决定因素，较低的教育水平与较高的抑郁几率相关（OR 6. 65; AS 患者的 9% CI 1.36 至 32.51）和焦虑（OR 9.31；9% CI 1.39 至 62.19）。我们的系统回顾和荟萃分析显示，AS 患者的抑郁和焦虑风险增加。这些发现表明监测和护理 AS 中的精神疾病的重要性。