Epidemiology of depression in schizophrenia patients living in Africa: a systematic review and meta-analysis
Notice bibliographique
Résumé
Introduction Various comorbid conditions can worsen the morbidity and mortality of schizophrenia, and this is the case for depression, especially through suicidal behaviors and cardiometabolic impairments. There is a scarcity of summarizing data on depressive symptoms and disorders among schizophrenia patients living in Africa. Objectives The aim of this meta-analytic review was to estimate the prevalence of depression in people living with schizophrenia in Africa. Methods We systematically searched for relevant articles published from inception to July 05, 2022, in PubMed/MEDLINE, EMBASE, and African Journals Online. We appraised the risk of bias using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for studies reporting prevalence data, and estimated the pooled prevalence of depression among patients with schizophrenia using a random-effects meta-analytic model. We performed meta-regression and subgroup analyses to assess potential mediators of our estimates. We based the report of our findings on the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (2020). We registered our protocol in PROSPERO (CRD42022315717). Results From 791 initial records, 10 studies were finally included in our qualitative and quantitative syntheses (Figure 1). These studies encompassed 2265 patients with schizophrenia (male-to-female ratio = 1.94), and were conducted between 2001 and 2019, in Egypt (n = 1/10), Ethiopia (n = 4/10), Morocco (n = 1/10), Nigeria (n = 1/10), South Africa (n = 2/10), and Tunisia (n = 1/10). The mean age of participants ranged from 33.8 to 49.2 years, and the most used tool was the Calgary Depression Scale for Schizophrenia (n = 4/10). The pooled prevalence rate of depression was 23.93% (95% CI: 19.43% – 28.73%), with substantial heterogeneity ( I ² = 84%). The prevalence of depression significantly varied according to screening tool used. The frequencies for Northern and Sub-Saharan Africa were respectively 31.9% (95% CI: 24.8% – 39.5%) and 21.1% (95% CI: 16.7% – 25.9%), with a significant difference between these subgroups (Figure 2). A higher prevalence of depression was associated with a lower percentage of schizophrenia patients with high education levels. Among schizophrenia people with depression (n = 250), 46.04% (95% CI: 30.07% – 62.42%) reported past or current suicide behaviors. The risk of bias was low for three studies, moderate for two studies, and high for five studies. The certainty was very low, and we found no publication bias. Image: Image 2: Conclusions Approximately one in every four schizophrenia patients living in Africa was positively screened for depression. This review draws health professionals’ attention caring people with schizophrenia, and calls for further studies with a harmonization of screening tool, a better representativity of some subregions, and the assessment of key potential factors such as perceived stigma and self-stigma. Disclosure of Interest None Declared
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,011 | 0,002 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».