INTRODUCTION People living with chronic diseases are at an increased risk of anxiety and depression, which are associated with poorer medical and psychosocial outcomes. Many studies have examined the trajectories of depression and anxiety in people with specific diseases, including the predictors of these trajectories. This is valuable for understanding the process of adjustment to diseases and informing treatment planning. However, no review has yet synthesised this information across chronic diseases. METHODS Electronic databases were searched for studies reporting trajectories of depression or anxiety in chronic disease samples. Data extracted included sample characteristics, results from trajectory analyses, and predictors of trajectories. Meta-analysis of the overall pooled prevalence of depression and anxiety trajectories was conducted, and qualitative synthesis of disease severity predictors was undertaken. RESULTS Following search and screening, 67 studies were included (N = 61,201 participants). Most participants followed a stable nonclinical trajectory for depression (69.0% [95% CI: 65.6, 72.2]) and anxiety (73.4% [95% CI: 66.3, 79.5]). Smaller but meaningful subsamples followed a trajectory of depression and anxiety symptoms consistently in the clinical range (11.8% [95% CI: 9.2, 14.8] and 13.7% [95% CI: 9.3, 19.7], respectively). Several clinical and methodological moderators emerged, and qualitative synthesis suggested that few aspects of disease severity were associated with participants' trajectories. CONCLUSION Most people with chronic disease follow a trajectory of distress that is low and stable, suggesting that most people psychologically adjust to living with chronic disease. Evidence also suggests that the nature and severity of the disease are not meaningful predictors of psychological distress.

中文翻译：

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慢性病中的抑郁和焦虑轨迹：系统回顾和荟萃分析。


简介 患有慢性疾病的人患焦虑和抑郁的风险增加，这与较差的医疗和社会心理结果有关。许多研究检查了患有特定疾病的人的抑郁和焦虑轨迹，包括这些轨迹的预测因子。这对于了解疾病调整过程并为治疗计划提供信息非常有价值。然而，尚未有综述综合慢性疾病的这些信息。方法 在电子数据库中搜索报告慢性病样本中抑郁或焦虑轨迹的研究。提取的数据包括样本特征、轨迹分析结果和轨迹预测因子。对抑郁和焦虑轨迹的总体汇总患病率进行了荟萃分析，并对疾病严重程度预测因素进行了定性综合。结果 经过检索和筛选，纳入了 67 项研究（N = 61,201 名参与者）。大多数参与者的抑郁症（69.0% [95% CI: 65.6, 72.2]）和焦虑症（73.4% [95% CI: 66.3, 79.5]）遵循稳定的非临床轨迹。较小但有意义的子样本遵循临床范围内一致的抑郁和焦虑症状轨迹（分别为 11.8% [95% CI: 9.2, 14.8] 和 13.7% [95% CI: 9.3, 19.7]）。出现了一些临床和方法学调节因素，定性综合表明疾病严重程度的几个方面与参与者的轨迹相关。结论 大多数慢性病患者的痛苦轨迹较低且稳定，这表明大多数人在心理上适应了慢性病患者的生活。 有证据还表明，疾病的性质和严重程度并不是心理困扰的有意义的预测因素。