Prevalence and predictors of depression and anxiety in patients with chronic rhinosinusitis: a systematic review and meta-analysis

Abstract

Background Chronic rhinosinusitis (CRS) is a persistent inflammation of the sinuses. As a result of long-term discomfort, patients may experience symptoms of common mental disorders such as anxiety and depression. This may affect the quality of life and disease progression. However, there is still uncertainty about the extent of the problem. Objective This meta-analysis aimed to determine the prevalence of depression and anxiety symptoms in patients with CRS. Search strategy We searched PubMed, Embase, Web of Science, Cochrane Library, and CBM databases for relevant studies published before 15 July 2022 in patients with CRS with concomitant depression and anxiety symptoms. Data collection and analysis Two authors independently performed screening and quality assessment using validated tools. Extraction of data using predefined standardised data collection spreadsheets. Heterogeneity and inconsistency were checked using the I2 statistic. Results The meta-analysis included 32 articles involving 56 933 patients. The prevalence of depression and anxiety symptoms was estimated at 24.7% (95% CI, 21.3% to 28. 1%) and 29.7% (95% CI, 19.3% to 40.2%). Subgroup analysis revealed the following: (1) CRS without nasal polyps (CRSsNP): 26.2% (95% CI, 21.9% to 30.5%), CRS with nasal polyps(CRSwNP): 20% (95% CI, 15.9% to 24%); (2) Female patients: 36. 1% (95% CI, 25.3% to 46.9%), male patients: 24.3% (95% CI, 12. 1% to 36.6%); and (3) The average age≤50 years patients: 29.8% (95% CI, 21.3% to 38.2%), the average age>50 years patients: 22. 1% (95% CI, 17.1% to 27%). Conclusion A significant proportion of people with CRS have symptoms of depression and anxiety, and early screening for depression and anxiety in people with CRS is critical. And, more attention needs to be given to females and patients with CRSsNP during screening. could be that individuals with CRS may have poor treat- for eligible reports that were not collected in the above ment adherence due to mental health issues, and this databases. may nourish a vicious cycle of mental health problems and physical health problems. Besides the rising treat- Quality assessment and risk of bias assessment ment costs, the poor treatment effects often lead to the Two evaluators independently assessed the quality of the discontent of patients and frustration of medical staff. selected studies using The Joanna Briggs Institute Prev-Considering the negative impact of depression on CRS alence Critical Appraisal Tool. The 10 questions in the patients, it is essential to screen for unbroken depression. assessment tool include the following: (1) Was the sample Furthermore, it is important to comprehend the intri- representative of the target population? (2) Were particicate relationships that exist between comorbidities and pants recruited in an appropriate way? (3) Was the sample depression linked to CRS. size adequate? (4) Were the study subjects and the setting