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Cited by 486Mental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesTreatment of Major Depression

Prevalence of depression and depressive symptoms among outpatients: a systematic review and meta-analysis

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Wang, Jinghui, Wu, Xiaohang, Lai, Weiyi, Long, Erping, Zhang, Xiayin, Li, Wangting, Zhu, Yi, Chen, Chuan +4 more·2017·BMJ Open
DOI 10.1136/bmjopen-2017-017173PMC PMC5640125
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Abstract

Objectives Depression and depressive symptoms are common mental disorders that have a considerable effect on patients’ health-related quality of life and satisfaction with medical care, but the prevalence of these conditions varies substantially between published studies. The aim of this study is to conduct a systematic review and meta-analysis to provide a precise estimate of the prevalence of depression or depressive symptoms among outpatients in different clinical specialties. Design Systematic review and meta-analysis. Data sources and eligibility criteria The PubMed and PsycINFO, EMBASE and Cochrane Library databases were searched to identify observational studies that contained information on the prevalence of depression and depressive symptoms in outpatients. All studies included were published before January 2016. Data characteristics were extracted independently by two investigators. The point prevalence of depression or depressive symptoms was measured using validated self-report questionnaires or structured interviews. Assessments were pooled using a random-effects model. Differences in study-level characteristics were estimated by meta-regression analysis. Heterogeneity was assessed using standard χ 2 tests and the I 2 statistic. The study protocol has been registered with PROSPERO under number CRD42017054738. Results Eighty-three cross-sectional studies involving 41 344 individuals were included in this study. The overall pooled prevalence of depression or depressive symptoms was 27.0% (10 943/41 344 individuals; 95% CI 24.0% to 29.0%), with significant heterogeneity between studies (p<0.0001, τ 2 =0.3742, I 2 =96.7%). Notably, a significantly higher prevalence of depression and depressive symptoms was observed in outpatients than in the healthy controls (OR 3.16, 95% CI 2.66 to 3.76, I 2 =72.0%, χ 2 =25.33). The highest depression/depressive symptom prevalence estimates occurred in studies of outpatients from otolaryngology clinics (53.0%), followed by dermatology clinics (39.0%) and neurology clinics (35.0%). Subgroup analyses showed that the prevalence of depression and depressive symptoms in different specialties varied from 17.0% to 53.0%. The prevalence of depression and depressive symptoms was higher among outpatients in developing countries than in outpatients from developed countries. Moreover, the prevalence of depression and depressive symptoms in outpatients slightly decreased from 1996 to 2010. Regarding screening instruments, the Beck Depression Inventory led to a higher estimate of the prevalence of depression and depressive symptoms (1316/4702, 36.0%, 95% CI 29.0% to 44.0%, I 2 =94.8%) than the Hospital Anxiety and Depression Scale (1003/2025, 22.0%, 95% CI 12.0% to 35.0%, I 2 =96.6%). Conclusion Our study provides evidence that a significant proportion of outpatients experience depression or depressive symptoms, highlighting the importance of developing effective management strategies for the early identification and treatment of these conditions among outpatients in clinical practice. The substantial heterogeneity between studies was not fully explained by the variables examined.

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Authors
Wang, J., Wu, X., Lai, W., Long, E., Zhang, X., Li, W., Zhu, Y., Chen, C., Zhong, X., Liu, Z., Wang, D., & Lin, H.
Affiliations
  • Sun Yat-sen University (CN)
  • University of Miami (US)
Corresponding author
Lin, Haotian
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2017-08
Volume
7
Issue
8
Pages
e017173
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2017-017173
PMC
PMC5640125
OpenAlex
W2746673885
Cited by
486
References
137
Citations by year
2026: 26 · 2025: 51 · 2024: 77 · 2023: 78 · 2022: 70 · 2021: 70 · 2020: 63 · 2019: 35 · 2018: 14 · 2017: 1
FWCI
4.86
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
  • Guangdong Provincial Natural Science Foundation for Distinguished Young Scholars of China
  • Pearl River Scholar Program of Guangdong Province, the Outstanding Young Teacher Cultivation Projects in Guangdong Province
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
depression, depressive symptoms, prevalence, outpatients, primary care, otolaryngology, dermatology, neurology, developing countries, temporal trends, health-related quality of life, patient satisfaction, mental health
MeSH terms
Depression, Depressive Disorder, Humans, Outpatients, Psychiatric Status Rating Scales, Quality of Life

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