Meta-Analysis of High Prevalence of Depression among Breast Cancer Survivors in Iran: Calling Community Supportive Care Programs

Ahmadi Gharaei, Hasan; Dianati nasab, Mostafa; Kouhestani, Seyyed Mostafa; Fararouei, Mohammad; Moameri, Hossein; Pakzad, Reza; Ghaiasvand, Reza

doi:2019.0.0.e2019030

Review paper

Epidemiology and Health 2019;e2019030.
DOI: https://doi.org/10.4178/epih.e2019030 [Accepted] Published online July 4, 2019.

Meta-Analysis of High Prevalence of Depression among Breast Cancer Survivors in Iran: Calling Community Supportive Care Programs

Hasan Ahmadi Gharaei¹

, Mostafa Dianati nasab²

, Seyyed Mostafa Kouhestani³

, Mohammad Fararouei⁴

, Hossein Moameri¹

, Reza Pakzad¹

, Reza Ghaiasvand⁵

¹Department of Epidemiology, Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
²Department of Epidemiology, Tehran University of Medical Sciences, Tehran, Iran
³School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
⁴Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
⁵Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway

Correspondence Mostafa Dianati nasab ,Tel: +987137251020, Fax: +987137251020, Email: dianati.epid@shmu.ac.ir

Received: May 15, 2019 Accepted after revision: July 4, 2019

Abstract

Objectives:
Depression is the most common comorbidity in breast cancer (BC) patients which has adverse effects on patients’ quality of life (QoL), disease progress and survival.
Method:
The study protocol was registered in the PROSPERO (registration number: CRD42019121494). We electronically searched published studies up to January 2019 with the aim of finding articles that investigated the prevalence of depression among breast cancer survivors. Web of Science (ISI), Scopus, PubMed/Medline, Science Direct and Google Scholar were searched to obtain the relevant published studies. This review included 15 cross-sectional and 3 cohort studies published from 2000 to 2018. We used a random effects model to conduct the meta-analysis and generate a summary estimate for the pooled prevalence with 95% confidence interval (CI). Subgroup analysis was also conducted based on depression assessment tool and study design.
Results:
The total sample size of the studied patients contained 2799 women with breast cancer which included 1228 cases who were diagnosed with depression. The pooled prevalence of depression among Iranian women with BC was 46.8% (95% CI: 33.8% – 59.9%) with significant heterogeneity (I2= 98.7% (p< 0.001). The prevalence of depression ranged from 14.00 % (95% CI: 4.9%-23.1%) to 95.9% (95% CI: 91.97%-99.83%). The results of subgroup analyses suggested that depression measuring tools, years of publication and study design were the source of heterogeneity.
Conclusions:
Our findings indicate a high prevalence of depression among breast cancer patients. The findings urge clinicians and health authorities to provide well defined social and psychological supportive care program for these patients.

Keywords: Breast cancer; Supportive care; Depression; Prevalence; Meta-analysis; Iran