Are We overestimating the prevalence of depression in chronic illness using questionnaires? Meta-analytic evidence in obstructive sleep apnoea

TY - JOUR

T1 - Are We overestimating the prevalence of depression in chronic illness using questionnaires? Meta-analytic evidence in obstructive sleep apnoea

AU - Nanthakumar, Shenooka

AU - Bucks, Romola S.

AU - Skinner, Timothy C.

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Depression is common in chronic illness, albeit prevalence can be highly variable. This variability may be a function of symptom overlap between depression and chronic illness. Using Obstructive Sleep Apnoea (OSA) as an exemplar, this meta-analysis explored whether the proportion of overlapping symptoms between OSA and depression, within different depression questionnaires, moderates prevalence estimates. Methods: A systematic search identified 13 studies meeting eligibility criteria. Results: Based on depression questionnaires, the prevalence of depression in OSA ranged from 8% to 68%, reflecting marked heterogeneity. Prevalence estimates based on questionnaires with greater symptom overlap between OSA and depression were higher, whereas questionnaires with a higher proportion of anhedonia symptoms were associated with lower prevalence estimates. Discussion: Overall, these data suggest that when using depression questionnaires to assess the prevalence of depression in OSA, questionnaires that have a lower proportion of symptom overlap between OSA and depression, as well as a higher proportion of anhedonia symptoms, reduce the likelihood of overestimating the prevalence of depression in OSA. This study has implications for other chronic illnesses with symptom overlap with depression, for example diabetes, chronic kidney disease, or heart disease, as well as suggesting that depression questionnaires are not equally appropriate for assessing depression symptomatology in chronic illness populations.

AB - Depression is common in chronic illness, albeit prevalence can be highly variable. This variability may be a function of symptom overlap between depression and chronic illness. Using Obstructive Sleep Apnoea (OSA) as an exemplar, this meta-analysis explored whether the proportion of overlapping symptoms between OSA and depression, within different depression questionnaires, moderates prevalence estimates. Methods: A systematic search identified 13 studies meeting eligibility criteria. Results: Based on depression questionnaires, the prevalence of depression in OSA ranged from 8% to 68%, reflecting marked heterogeneity. Prevalence estimates based on questionnaires with greater symptom overlap between OSA and depression were higher, whereas questionnaires with a higher proportion of anhedonia symptoms were associated with lower prevalence estimates. Discussion: Overall, these data suggest that when using depression questionnaires to assess the prevalence of depression in OSA, questionnaires that have a lower proportion of symptom overlap between OSA and depression, as well as a higher proportion of anhedonia symptoms, reduce the likelihood of overestimating the prevalence of depression in OSA. This study has implications for other chronic illnesses with symptom overlap with depression, for example diabetes, chronic kidney disease, or heart disease, as well as suggesting that depression questionnaires are not equally appropriate for assessing depression symptomatology in chronic illness populations.

KW - Chronic illness

KW - Depression

KW - Obstructive sleep apnoea

KW - Prevalence

KW - Sleep apnea

UR - http://www.scopus.com/inward/record.url?scp=84946060032&partnerID=8YFLogxK

U2 - 10.1037/hea0000280

DO - 10.1037/hea0000280

M3 - Journal article

C2 - 26523355

AN - SCOPUS:84946060032

SN - 0278-6133

VL - 35

SP - 423

EP - 432

JO - Health Psychology

JF - Health Psychology

IS - 5

ER -