Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jan 19, 2024; 14(1): 179-193
Published online Jan 19, 2024. doi: 10.5498/wjp.v14.i1.179
Global epidemiology of mental disorder in atrial fibrillation between 1998-2021: A systematic review and meta-analysis
Shuai Zhang, Na Zhang, Liu Liu, Wang Zheng, Zi-Lin Ma, Si-Yu Qiao, Ying-Li Zhao, Yi-Hong Wei, Gang Wu, Qiu-Ting Yu, Bing Deng, Lin Shen
Shuai Zhang, Na Zhang, Wang Zheng, Zi-Lin Ma, Si-Yu Qiao, Ying-Li Zhao, Yi-Hong Wei, Gang Wu, Qiu-Ting Yu, Bing Deng, Lin Shen, Department of Cardiology, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
Liu Liu, Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
Co-first authors: Shuai Zhang and Na Zhang.
Co-corresponding authors: Shuai Zhang and Lin Shen.
Author contributions: Zhang S and Shen L were co-corresponding authors who proposed the concept, designed the study and raised fundings; Zhang S and Zhang N were co-first authors for they contributed equally in this research. Additionally, Zhang S, Liu L and Zhang N were responsible for literature search, screening and writing drafts; Zheng W and Ma ZL extracted data; Zhang YL and Qiao SY assessed the quality of studies; Wei YH, Wu G, Yu QT and Deng B analyzed the data. All the authors read and approved the final manuscript. The reasons for designating Zhang S and Zhang N as co-first authors are twofold: Firstly, they made equal contributions to the writing and revision of the manuscript. Secondly, this study was conducted collaboratively, and appointing Zhang S and Zhang N as co-first authors facilitate effective communication in addressing issues related to research design, writing, and data analysis, thereby ensuring smooth progress in the research. The rationale behind selecting Zhang S and Shen L as co-corresponding authors lies in their equal contributions to formulating, conceptualizing, and executing the study, as well as providing funding support. In summary, the co-first and co-corresponding authors in this study not only ensured its seamless execution but also enhanced the rationality and depth of the research topic.
Supported by the Fourth Batch of National Excellent Talents in Chinese Medicine Project, No. Lh01.40.002; and the Third Batch of Excellent Young Talents Clinical Competency Enhancement Program of Longhua Hospital, No. RC-2020-01-12.
Conflict-of-interest statement: The authors declare no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shuai Zhang, MD, Doctor, Department of Cardiology, LongHua Hospital Shanghai University of Traditional Chinese Medicine, No. 725 South Wanping Road, Shanghai 200032, China. dr_shuaizh@163.com
Received: November 1, 2023
Peer-review started: November 1, 2023
First decision: November 17, 2023
Revised: November 27, 2023
Accepted: December 20, 2023
Article in press: December 20, 2023
Published online: January 19, 2024
Processing time: 79 Days and 5.7 Hours
Abstract
BACKGROUND

As the burden of mental disorders among patients with atrial fibrillation (AF) increases, researchers are beginning to pay close attention to the risk and prevalence of these comorbidities. Although studies have independently analyzed the risk of comorbidity with depression and anxiety in patients with AF, no study has systematically focused on the global epidemiology of these two mental disorders.

AIM

To explore the prevalence of depression and anxiety in patients with AF.

METHODS

Five databases were searched from their date of establishment until January 2023. Observational studies reporting the comorbidity of AF with depression and anxiety, were included in this study. Basic information, such as the first author/ publication year, study year, study type, and prevalence of depression and anxiety, were extracted. STATA SE 15.1 was used to analyze the data. Subgroup, meta-regression, and sensitivity analyses were performed to estimate study heterogeneity.

RESULTS

After a thorough search, 26 studies were identified and included in this meta-analysis. The prevalence rates of depression and anxiety in adults with AF were 24.3% and 14.5%, respectively. Among adult males with AF, the prevalence was 11.7% and 8.7%, respectively, whereas in females it was 19.8% and 10.1%, respectively. In older adults with AF, the prevalence rates of depression and anxiety were 40.3% and 33.6%, respectively. The highest regional prevalence of depression and anxiety was observed in European (30.2%) and North American (19.8%) patients with AF.

CONCLUSION

In this study, we found that the prevalence of depression and anxiety among patients with AF varies with sex, region, and evaluation scales, suggesting the need for psychological interventions for patients with AF in clinical practice.

Keywords: Atrial fibrillation; Depression; Anxiety; Prevalence

Core Tip: Mental disorders are risk factors for the development of atrial fibrillation (AF). The global prevalence of AF comorbidity with depression and anxiety is not clear. This is the first study to evaluate the global prevalence of two types of psychiatric disorders (depression and anxiety) in patients with AF from the aspects of age, sex, country, and evaluation scale for depression and anxiety.