The prevalence of anxiety and depression in cardiac arrest survivors: A systematic review and meta-analysis

Xiaoli Chen; Dongze Li; Lin He; Wenjie Yang; Min Dai; Lin Lan; Dongmei Diao; Liqun Zou; Peng Yao; Yu Cao

doi:10.1016/j.genhosppsych.2023.03.013

The prevalence of anxiety and depression in cardiac arrest survivors: A systematic review and meta-analysis

Gen Hosp Psychiatry. 2023 Jul-Aug:83:8-19. doi: 10.1016/j.genhosppsych.2023.03.013. Epub 2023 Mar 28.

Authors

Xiaoli Chen¹, Dongze Li¹, Lin He², Wenjie Yang³, Min Dai¹, Lin Lan¹, Dongmei Diao¹, Liqun Zou¹, Peng Yao¹, Yu Cao⁴

Affiliations

¹ Department of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China; Disaster Medical Center, Sichuan University, Chengdu, China.
² The Intelligence Library Center, Ministry of Science and Technology, Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
³ Center of Biostatistics, Design, Measurement and Evaluation (CBDME), West China Hospital, Sichuan University, Chengdu, China.
⁴ Department of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China; Disaster Medical Center, Sichuan University, Chengdu, China. Electronic address: caoyu@wchscu.cn.

PMID: 37028095
DOI: 10.1016/j.genhosppsych.2023.03.013

Abstract

Objective: This systematic review aimed to identify the prevalence of anxiety and depression in cardiac arrest (CA) survivors.

Methods: A systematic review and network meta-analysis was performed on observational studies in adult cardiac arrest survivors with psychiatric disorders from PubMed, Embase, Cochrane Library and Web of Science. In the meta-analysis, we combined the prevalence quantitatively and analyzed the subgroup based on the classification indexes.

Results: We identified 32 articles that met the inclusion criteria. Regarding anxiety,the pooled prevalence was 24% (95% CI, 17-31%) and 22% (95% CI, 13-26%) in short-term and long-term respectively. The subgroup analysis showed that the pooled incidence in in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrests (OHCA) survivors was 14.0% (95%CI, 9.0-20.0%) and 28.0% (95%CI, 20.0-36.0%) for short-term anxiety.The incidence of anxiety measured by, Hamilton Anxiety Rating Scale(HAM-A) and State-Trait Anxiety Inventory(STAI) was higher than other tools(P < 0.01). Regarding depression,the data analysis showed that the pooled incidence of short-term and long-term depression was 19% (95% CI, 13-26%) and 19% (95% CI, 16-25%), respectively. The subgroup analysis showed that the incidence of short-term and long-term depression was 8% (95% CI, 1-19%) and 30% (95% CI, 5-64%) for IHCA survivors, and was 18% (95% CI, 11-26%) and 17% (95% CI, 11-25%) for OHCA survivors. The incidence of depression measured by Hamilton Depression Rating Scale(HDRS) and Symptom check list-90(SCL-90) was higher than other assessment tools(P < 0.01).

Conclusions: The meta-analysis indicated a high prevalence of anxiety and depression in CA survivors, and those symptoms persisted 1 year or more after CA. Evaluation tool is an important factor affecting the measurement results.

Keywords: Anxiety; Cardiac arrest; Cardiopulmonary resuscitation; Depression; Psychiatric disorders.

Publication types

Meta-Analysis
Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anxiety / diagnosis
Anxiety / epidemiology
Depression* / diagnosis
Depression* / epidemiology
Humans
Out-of-Hospital Cardiac Arrest* / epidemiology
Out-of-Hospital Cardiac Arrest* / psychology
Out-of-Hospital Cardiac Arrest* / therapy
Prevalence
Survivors / psychology