Background
Methods
Overview
Eligibility criteria
Search strategy
Study selection
Data extraction
Quality assessment
Qualitative synthesis
Quantitative synthesis
Results
Characteristics of the primary studies
Methodological quality assessment of primary studies
Epidemiology of depression among HCWs in the EMR
Studied subgroups | Years of data collection | Number of prevalence measures | Total sample size | Prevalence range (%) | Effect size | Subgroup Comparison | Heterogeneity between studies | |||
---|---|---|---|---|---|---|---|---|---|---|
Weighted average prevalence (%) | 95% CI | Q between subgroup tests p value | Cochrane Q test's p value | I2 (%) | 95% prediction intervala | |||||
EMR | ||||||||||
All countries (Egypt, Iran, Lebanon, Oman, Pakistan, Saudi Arabia and the United Arab Emirates) | 2005–2020 | 94 | 26,029 | 2.40–99.90 | 33.03 | 27.40–39.19 | N/A | < 0.0001 | 98.80 | 3.53–86.94 |
By period | ||||||||||
< 2011 | 2005–2010 | 23 | 5810 | 2.40–81.81 | 25.80 | 17.84–35.76 | 0.3860 | < 0.0001 | 98.00 | 3.05–79.34 |
2011–2019 | 2011–2019 | 38 | 10,682 | 2.51–92.90 | 33.87 | 25.05–43.99 | < 0.0001 | 98.90 | 3.26–88.61 | |
2020 | 2020 | 10 | 3363 | 24.00–99.90 | 46.12 | 21.30–73.02 | < 0.0001 | 99.50 | 1.02–98.61 | |
Sex | ||||||||||
Females | 2012–2017 | 5 | 1285 | 2.90–53.80 | 23.35 | 8.24–50.82 | 0.1154 | < 0.0001 | 97.30 | 8.24–50.82 |
Males | 2017–2018 | 3 | 310 | 26.70–57.10 | 53.43 | 27.43–77.69 | < 0.0001 | 90.60 | 0.00–100.00 | |
Profession | ||||||||||
Health Care Workers | 2010–2020 | 12 | 3814 | 25.00–99.90 | 55.22 | 33.14–75.41 | 0.2261 | < 0.0001 | 99.40 | 3.03–97.99 |
Doctors | 2008–2020 | 17 | 3368 | 6.10–85.30 | 36.27 | 24.70–49.69 | < 0.0001 | 97.90 | 4.46–87.42 | |
Residents | 2012–2020 | 26 | 7003 | 1.70–81.81 | 32.78 | 22.08–45.63 | < 0.0001 | 98.80 | 2.66–89.68 | |
Nurses | 2005–2020 | 49 | 11,942 | 2.40–92.90 | 26.87 | 20.67–34.12 | < 0.0001 | 98.30 | 3.07–80.97 | |
EMTs | 2017–2019 | 2 | 344 | 26.70–41.00 | 32.89 | 23.63–43.71 | 0.0073 | 72.00 | N/A | |
Allied Health Staff | 2008–2020 | 3 | 428 | 7.80–63.20 | 26.39 | 7.97–59.74 | < 0.0001 | 96.80 | 0.00–100.00 | |
Specialty | ||||||||||
Internal Medicine | 2013–2017 | 3 | 419 | 3.00–46.00 | 20.54 | 4.42–59.10 | 0.0001 | < 0.0001 | 96.40 | 0.00–100.00 |
Surgery | 2013–2017 | 3 | 178 | 1.70–70.60 | 12.66 | 1.16–64.11 | < 0.0001 | 92.70 | 0.00–100.00 | |
Obstetrics & Gynecology | 2013 | 1 | 20 | 12.00 | 10.00 | 2.51–32.38 | N/A | N/A | N/A | |
Family Medicine | 2014–2016 | 2 | 279 | 20.00–22.00 | 20.43 | 16.10–25.57 | 0.7560 | 0.00 | N/A | |
Emergency Medicine | 2014–2016 | 3 | 403 | 31.40–81.81 | 53.14 | 26.63–77.99 | < 0.0001 | 96.00 | 0.00–100.00 | |
Radiology | 2017 | 1 | 45 | 2.20 | 2.22 | 0.31–14.16 | N/A | N/A | N/A |
Sensitivity analysis of depression prevalence by instrument
Studied subgroups | Years of data collection | Number of prevalence measures | Total sample size | Prevalence range (%) | Effect size | Subgroup comparison | Heterogeneity between studies | |||
---|---|---|---|---|---|---|---|---|---|---|
Weighted average prevalence (%) | 95% CI | Q between subgroup tests p value | Cochrane Q test's p value | I2 (%) | 95% prediction intervala | |||||
EMR | ||||||||||
All countries (Egypt, Iran, Lebanon, Oman, Pakistan, Saudi Arabia and the United Arab Emirates) | 2005–2020 | 94 | 26,029 | 2.40–99.90 | 33.03 | 27.40–39.19 | N/A | < 0.0001 | 98.80 | 3.53–86.94 |
Diagnostic Instrumentsb | 2012–2015 | 5 | 1192 | 2.90–81.81 | 26.31 | 6.29–65.50 | 0.6949 | < 0.0001 | 99.10 | 0.05–99.61 |
Screening Instruments | 2005–2020 | 89 | 24,837 | 2.40–99.90 | 33.37 | 27.74–39.53 | < 0.0001 | 98.80 | 3.87–86.16 | |
BDI | 2005–2018 | 25 | 6679 | 7.80–89.25 | 33.33 | 24.91–42.97 | < 0.0001 | < 0.0001 | 97.90 | 5.43–81.31 |
BDI–2 | 2006–2018 | 8 | 1082 | 22.00–92.90 | 45.90 | 26.88–66.18 | < 0.0001 | 97.20 | 3.80–94.80 | |
BDI–SF | 2017 | 1 | 247 | 9.88 | 9.72 | 6.60–14.09 | N/A | N/A | N/A | |
DASS–21 | 2010–2020 | 18 | 4903 | 9.50–99.90 | 40.21 | 26.04–56.22 | < 0.0001 | 99.00 | 3.22–93.15 | |
DASS–42 | 2007–2016 | 2 | 470 | 2.40–29.10 | 9.23 | 1.36–42.79 | N/A | 95.40 | N/A | |
HADS | 2012–2020 | 14 | 4412 | 6.10–82.00 | 26.05 | 15.98–39.47 | < 0.0001 | 98.30 | 2.53–82.72 | |
PHQ–9 | 2013–2020 | 10 | 4332 | 2.51–71.4 | 33.89 | 18.20–54.15 | < 0.0001 | 99.20 | 2.01–92.77 | |
Otherc | 2006–2016 | 11 | 2712 | 6.20–85.10 | 33.45 | 18.47–52.73 | < 0.0001 | 98.30 | 2.15–92.00 |
Geographical pattern of depression prevalence
Studied subgroups | Years of data collection | Number of prevalence measures | Total sample size | Prevalence range (%) | Effect size | Subgroup Comparison | Heterogeneity between studies | |||
---|---|---|---|---|---|---|---|---|---|---|
Weighted average prevalence (%) | 95% CI | Q between subgroup tests p value | Cochrane Q test's p value | I2 (%) | 95% prediction intervala | |||||
EMR | ||||||||||
All countries (Egypt, Iran, Lebanon, Oman, Pakistan, Saudi Arabia and the United Arab Emirates) | 2005–2020 | 94 | 26,029 | 1.70–99.90 | 33.03 | 27.40–39.19 | N/A | < 0.0001 | 98.80 | 3.53–86.94 |
Egypt | ||||||||||
All professions | 2013–2018 | 10 | 2507 | 20.00–92.90 | 55.69 | 41.74–68.79 | N/A | < 0.0001 | 97.50 | 12.98–91.37 |
Doctors | 2016 | 2 | 961 | 52.00–65.40 | 58.92 | 49.34–67.88 | 0.0716 | < 0.0001 | 88.70 | N/A |
Residents | 2013–2018 | 4 | 641 | 20.00–59.52 | 40.06 | 25.51–56.61 | < 0.0001 | 92.40 | 2.80–93.94 | |
Nurses | 2013–2016 | 4 | 645 | 45.00–92.90 | 69.16 | 46.25–85.39 | < 0.0001 | 95.90 | 2.32–99.53 | |
All specialties | No data | |||||||||
Iran | ||||||||||
All professions | 2005–2020 | 44 | 11,436 | 2.90–99.90 | 29.61 | 22.16–38.33 | N/A | < 0.0001 | 98.60 | 2.87–85.67 |
Health care workers | 2010–2020 | 4 | 670 | 43.4. –99.90 | 87.40 | 25.69–99.29 | 0.1089 | 0.0027 | 99.30 | 0.00–100.00 |
Doctors | 2020 | 1 | 127 | 26.80 | 26.77 | 19.80–35.13 | N/A | N/A | N/A | |
Residents | 2014–2015 | 2 | 2449 | 31.20–81.81 | 58.60 | 22.26–87.50 | < 0.0001 | 98.60 | N/A | |
Nurses | 2005–2020 | 36 | 7961 | 2.90–89.25 | 23.84 | 18.74–29.83 | < 0.0001 | 96.70 | 4.58–67.14 | |
Allied health staff | 2020 | 1 | 229 | 24.00 | 24.02 | 18.92–29.97 | N/A | N/A | N/A | |
All specialties | 2005–2020 | 44 | 11,436 | 2.90–99.90 | 29.61 | 22.16–38.33 | N/A | < 0.0001 | 98.60 | 2.87–85.67 |
Emergency medicine | 2014–2015 | 1 | 198 | 81.81 | 81.82 | 75.82–86.59 | < 0.0001 | N/A | N/A | N/A |
Lebanon | ||||||||||
All Professions | 2013 | 4 | 171 | 8.00–46.00 | 22.98 | 9.93–44.69 | N/A | 0.0062 | 81.30 | 0.41–95.63 |
Residents | 2013 | 3 | 80 | 8.00–46.00 | 17.75 | 5.46–44.65 | 0.0081 | 0.0026 | 73.70 | 0.00–100.00 |
Nurses | 2013 | 1 | 91 | 36.20 | 36.26 | 27.07–46.59 | N/A | N/A | N/A | |
All specialties | 2013 | 4 | 171 | 8.00–46.00 | 22.98 | 9.93–44.69 | N/A | 0.0062 | 81.30 | 0.41–95.63 |
Internal medicine | 2013 | 1 | 35 | 46.00 | 45.71 | 30.22–62.09 | 0.0062 | N/A | N/A | N/A |
Surgery | 2013 | 1 | 25 | 8.00 | 8.00 | 2.01–26.94 | N/A | N/A | N/A | |
Obestetrics & Gynecology | 2013 | 1 | 20 | 12.00 | 10.00 | 2.51–32.38 | N/A | N/A | N/A | |
Oman | ||||||||||
All professions | 2017 | 4 | 531 | 1.70–11.40 | 3.75 | 1.54–8.84 | N/A | 0.0023 | 69.9 | 0.09–61.61 |
Residents | 2017 | 4 | 531 | 1.70–11.40 | 3.75 | 1.54–8.84 | N/A | 0.0023 | 69.9 | 0.09–61.61 |
All specialties | 2017 | 4 | 531 | 1.70–11.40 | 3.75 | 1.54–8.84 | N/A | 0.0023 | 69.9 | 0.09–61.61 |
Internal Medicine | 2017 | 1 | 235 | 3.00–11.40 | 2.98 | 1.43–6.11 | 0.0023 | N/A | N/A | N/A |
Surgery | 2017 | 1 | 119 | 1.70 | 1.68 | 0.42–6.47 | N/A | N/A | N/A | |
Radiology | 2017 | 1 | 45 | 2.2 | 2.22 | 0.31–14.16 | N/A | N/A | N/A | |
Pakistan | ||||||||||
All professions | 2008–2020 | 11 | 2196 | 6.10–85.30 | 31.69 | 18.75–48.26 | N/A | < 0.0001 | 97.80 | 2.89–87.86 |
Health care workers | 2020 | 3 | 882 | 27.30–34.60 | 31.42 | 28.00–35.05 | 0.0081 | 0.1375 | 24.00 | 10.20–64.88 |
Doctors | 2008–2018 | 6 | 1209 | 6.10–85.30 | 27.53 | 9.87–56.85 | < 0.0001 | 97.40 | 0.37–97.46 | |
Residents | 2020 | 1 | 35 | 39.90 | 40.00 | 25.32–56.73 | N/A | N/A | N/A | |
Nurses | Not reported | 1 | 70 | 51.40 | 51.43 | 39.85–62.85 | N/A | N/A | N/A | |
All specialties | No data | |||||||||
Saudi Arabia | ||||||||||
All professions | 2012–2020 | 19 | 4211 | 7.10–70.60 | 35.70 | 26.96–45.51 | N/A | < 0.0001 | 96.80 | 7.62–78.90 |
Health Care Workers | 2013–2020 | 2 | 527 | 35.47–52.20 | 42.39 | 31.33–54.27 | 0.3543 | 0.0032 | 76.50 | N/A |
Doctors | 2015–2016 | 6 | 812 | 22.00–47.00 | 35.69 | 28.87–43.15 | 0.0002 | 76.20 | 16.50–60.93 | |
Residents | 2012–2018 | 6 | 610 | 19.90–70.60 | 46.34 | 27.55–66.22 | < 0.0001 | 94.40 | 4.30–94.32 | |
Nurses | 2014–2017 | 3 | 1918 | 7.10–53.80 | 17.78 | 5.15–46.27 | < 0.0001 | 98.90 | 0.00–100.00 | |
EMTs | 2017–2019 | 2 | 344 | 26.70–41.00 | 32.89 | 23.63–43.71 | 0.0073 | 72.00 | N/A | |
All specialties | 2012–2020 | 19 | 4211 | 7.10–70.60 | 35.70 | 26.96–45.51 | N/A | < 0.0001 | 96.80 | 7.62–78.90 |
Internal medicine | Not reported | 1 | 149 | 40.20 | 40.27 | 32.70–48.33 | < 0.0001 | N/A | N/A | N/A |
Surgery | 2017 | 1 | 34 | 70.60 | 70.59 | 53.44–83.39 | N/A | N/A | N/A | |
Emergency medicine | 2015–2016 | 2 | 205 | 31.40–41.00 | 34.63 | 28.44–41.40 | 0.1666 | 0.00 | N/A | |
Family medicine | 2015–2016 | 1 | 69 | 22.00 | 21.74 | 13.55–32.98 | N/A | N/A | N/A | |
UAE | ||||||||||
All professions | 2008–2016 | 5 | 727 | 7.80–65.50 | 44.2 | 22.60–68.25 | N/A | < 0.0001 | 97.00 | 1.62–97.45 |
Residents | 2012–2016 | 4 | 634 | 50.00–65.50 | 58.47 | 51.15–65.43 | < 0.0001 | 0.0066 | 63.9 | 29.95–82.25 |
Allied Health Staff | 2008 | 1 | 93 | 7.80 | 7.53 | 3.63–14.96 | N/A | N/A | N/A | |
All specialties | No data |
Time trend of depression prevalence
Overview of depression prevalence by HCW profession and specialty
Overview of depression prevalence by sex
Heterogeneity in studies describing depression prevalence
Risk and protective factors for depression among HCWs
Prevention | |
Provide support to ensure financial stability of communities [4] (Governmental & Community levels) | |
Treatment | |
Research | |