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Research ArticleGout

Epidemiology of Depression and Anxiety in Gout: A Systematic Review and Metaanalysis

Alyssa Howren, Drew Bowie, Hyon K. Choi, Sharan K. Rai and Mary A. De Vera
The Journal of Rheumatology January 2021, 48 (1) 129-137; DOI: https://doi.org/10.3899/jrheum.190974
Alyssa Howren
1A. Howren, MSc, M.A. De Vera, PhD, University of British Columbia, Faculty of Pharmaceutical Sciences, Vancouver, and Arthritis Research Canada, Richmond, and Collaboration for Outcomes Research and Evaluation, Vancouver, British Columbia, Canada;
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Drew Bowie
2D. Bowie, MD, University of British Columbia, Faculty of Medicine, Department of Medicine, Division of Internal Medicine, Vancouver, British Columbia, Canada;
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Hyon K. Choi
3H.K. Choi, MD, DrPH, Arthritis Research Canada, Richmond, British Columbia, Canada, and Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA;
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Sharan K. Rai
4S.K. Rai, MSc, Arthritis Research Canada, Richmond, British Columbia, Canada, and Department of Nutrition and Program in Population Health Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
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Mary A. De Vera
1A. Howren, MSc, M.A. De Vera, PhD, University of British Columbia, Faculty of Pharmaceutical Sciences, Vancouver, and Arthritis Research Canada, Richmond, and Collaboration for Outcomes Research and Evaluation, Vancouver, British Columbia, Canada;
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  • For correspondence: mdevera@mail.ubc.ca
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Abstract

Objective. To conduct a systematic review of depression and anxiety among patients with gout that specifically evaluates the prevalence, incidence, determinants, and effects of these mental health comorbidities.

Methods. We conducted a literature search in Medline, Embase, Cochrane Database of Systematic Reviews, CINAHL, and PsycINFO using indexed terms and key words to identify studies reporting on depression/anxiety in patients with gout. This review included full-text articles published in English that reported on patients with gout, evaluated depression/anxiety using a routinely reported measure, and provided estimates or sufficient data on the prevalence, incidence, determinants, or effects of depression/anxiety. Metaanalyses were conducted using random effects models.

Results. Twenty of 901 articles identified through the search strategy met our inclusion criteria. All 20 studies evaluated depression, while only 10 assessed anxiety (50%). Metaanalyses suggest a positive association between mental health disorders and gout, as resultant pooled OR were 1.29 (95% CI 1.07–1.56) for depression and 1.29 (95% CI 0.96–1.73) for anxiety. Findings from four studies reporting on the incidence of depression in patients with gout resulted in a pooled HR of 1.17 (95% CI 1.01–1.36). Significant determinants of depression included number of tophi, frequency of flares, and oligo/polyarticular gout.

Conclusion. Our systematic review suggests that depression and anxiety are significantly associated with gout, highlighting the need for future research to focus on the onset of mental disorders after gout diagnosis. We also identify potential targets for intervention.

Key Indexing Terms:
  • anxiety
  • depression
  • gout
  • mental disorders
  • metaanalysis
  • systematic review
  • Accepted for publication February 13, 2020.
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The Journal of Rheumatology
Vol. 48, Issue 1
1 Jan 2021
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Epidemiology of Depression and Anxiety in Gout: A Systematic Review and Metaanalysis
Alyssa Howren, Drew Bowie, Hyon K. Choi, Sharan K. Rai, Mary A. De Vera
The Journal of Rheumatology Jan 2021, 48 (1) 129-137; DOI: 10.3899/jrheum.190974

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Epidemiology of Depression and Anxiety in Gout: A Systematic Review and Metaanalysis
Alyssa Howren, Drew Bowie, Hyon K. Choi, Sharan K. Rai, Mary A. De Vera
The Journal of Rheumatology Jan 2021, 48 (1) 129-137; DOI: 10.3899/jrheum.190974
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Keywords

ANXIETY
DEPRESSION
GOUT
MENTAL DISORDERS
METAANALYSIS
SYSTEMATIC REVIEW

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