Table 4 Characteristics of included studies
From: Are depression, anxiety and poor mental health risk factors for knee pain? A systematic review
Author (country, year) | Study population | No. of participants | Age (years) | Definition of OA | Previous knee injury | Pain assessment | Psychosocial factor assessment | Quality score |
|---|---|---|---|---|---|---|---|---|
(% women) | mean ± SD (range) | |||||||
Cross-sectional Studies | ||||||||
O’Reilly (England, 1998) | Community participants registered at two general practices and aged 40–70 years | 3323 (NA) | NA (range: 40–75) | NA | NA | Questions regarding knee pain on most days for at least a month (in the past year) | General mental health: Short Form 36 (SF36) subscale | 45 |
Creamer (USA, 1999) | Recruited from the Baltimore Longitudinal Study of Aging; community-based individuals >40Â years | 374 (32) | Men: | NA | NA | Knee pain: National Health and Nutrition Examination Survey | Anxiety: Arthritis Impact Measurement Scales (AIMS) | 55 |
63.8 ±0.80 | ||||||||
Women: 62.8 ±1.08 | ||||||||
Depression: AIMS | ||||||||
Harcombe (New Zealand, 2010) | Randomly selected nurses, postal workers and office workers using computers | 443 (NA) | NA (range: 20–59) | NA | NA | Self-reported knee pain lasting for more than a day in the month before the survey | General Mental health: Mental Health Inventory-5 (MHI-5) | 73 |
Matsudaira (Japan, 2011) | Nurses, office workers, sales/marketing personnel and transportation operatives | 2290 (32) | NA (range: 19–64) | NA | NA | Self-reported knee pain in the past month and past year | General Mental health: SF36 subscale | 82 |
Creamer (USA, 1999) | Outpatients with prior physician diagnosis of knee OA and current knee pain | 68 (69.1) | 65.8 ± 10.4 | American College of Rheumatology clinical criteria | Excluded if previous total knee replacement | Knee Pain and Severity: WOMAC, VAS, MPQ | Depression: Centre for Epidemiological Studies Depression Scale (CES-D) | 55 |
Anxiety: State-Trait Anxiety Inventory (STAI) | ||||||||
Davis (USA, 1992) | Study sample from NHANES I survey, aged 45–74 years, who had knee OA and knee pain | 4056 (52) | (45–74) | OA based on radiographic criteria using the Atlas of Standard Radiographs of Arthritis. | NA | Knee pain on most days lasting one month in the past year or pain on active or passive motion during the examination | General Mental Health: NHANES General Wellbeing Index | 45 |
Salaffi (Italy, 1991) | 61 participants from outpatient clinic of a Rheumatic Disease Unit with symptomatic knee OA | 61 (100) | 63.5 ± 7.3 | American College of Rheumatology clinical criteria | NA | Knee Pain: MPQ and Visual Analogue Scale | Depression: Zung Depression Inventory | 45 |
Anxiety: Zung Anxiety Inventory | ||||||||
van Baar | Participants presenting to their GPs with hip and knee OA | Hip OA: 73 (71.2) | Hip OA: | American College of Rheumatology clinical criteria | Excluded if pathology explained the complaints | Severity of knee pain: Visual Analogue Scale | Anxiety and Depression: IRGL questionnaire | 64 |
(The Netherlands, 1998) | Knee OA: 112 (88.4) | 67.7 ± 8.7 | ||||||
Knee OA: 69.3 ± 8.1 | ||||||||
Pells (USA, 2008) | Subjects with knee OA recruited through Rheumatology, Orthopaedic Surgery, and Pain Management clinics | 174 (82) | 57.7 ± 9.8 | American College of Rheumatology clinical criteria | NA | Knee pain: AIMS | Depression and Anxiety: Psychological Disability subscale of AIMS | 64 |
Wright (USA, 2008) | Participants from the KNEE study, aged 35–64 years; pain on ≥4 days a week | 275 | NA (range 35–64) | American College of Rheumatology clinical criteria | Excluded if have inflammatory arthritis, previous knee surgery, Kellgren and Lawrence grade III-IV | Pain: WOMAC pain subscale | Depressive symptoms: CES-D | 82 |
Pain composite: pain assessments taken after physical function tests in pre-baseline assessment | ||||||||
General mental health (Vitality): subscale of the SF-36 | ||||||||
Nested case–control studies |  |  |  |  |  |  |  | |
Peat (United Kingdom, 2009) | Both cases and control are recruited from the Clinical Assessment Study of the Knee | 285 (55) | Cases: | NA | Previous knee surgery n (%): 26 (9.1) | Characteristic pain intensity: Chronic Pain Grade | Anxiety and depression: Hospital Anxiety and Depression Scale | 79 |
66.3 ± 9.2 | ||||||||
Controls: 64.6 ± 8.2 | ||||||||
Pain extent: areas of pain experienced in previous month shaded on whole-body manikin | ||||||||
Night pain: single item on WOMAC | ||||||||
Longitudinal Studies | ||||||||
Piva (USA, 2009) | Subjects diagnosed with patella-femoral pain syndrome (PFPS) recruited from rehabilitation clinics | 74 (52) | 29 ± 9 | NA | Excluded if previous patellar dislocation, knee surgery past 2 years, ligamentous injury or laxity, internal derangement | Knee pain intensity measured using 11-point numerical pain rating scale (NPRS) | Anxiety: Beck Anxiety Index | 85 |
Riddle (USA, 2011) | Community based recruitment through 4 teaching hospitals from different states (Osteoarthritis initiative study) | 3405 (59.1%) | 60.62 ±9.04 | Modified Kellgren and Lawrence Knee OA | NA | Knee Pain: WOMAC pain scale | General mental health: SF-12 Mental Component Summary (MCS) | 92 |
Disability: WOMAC disability scale | ||||||||
Depression: 20-item CES-D | ||||||||
Randomised controlled trials | ||||||||
Chappell | Male and female outpatients ≥ 40 years of age. Recruitment by clinical sites | Antidepressant (intervention)= 128(69.5%) | Antidepressant= 63.2 ± 8.8 | American College of Rheumatology clinical criteria | Excluded patients with invasive therapies to the index knee during the past 3 months or previous joint replacement anytime | Knee Pain: Brief Pain Inventory (BPI); WOMAC pain and stiffness subscales | Depression: Beck Depression Inventory-II (BDI-II); | 8* |
(USA, 2011) | ||||||||
Placebo= | ||||||||
Placebo Control= 128(83.6%) | 61.9 ± 9.2 | |||||||
in Canada, Greece, Russia, Sweden, and the USA by | Perceived improvement: Clinical Global Impressions of Severity (CGI-S) | Hospital Anxiety and Depression Scale anxiety subscale | ||||||
general practitioner and rheumatologists | ||||||||
(HADS-A) | ||||||||
Chappell | Outpatients of ≥40 years male and female with pain for 14 days of each month for 3 months before study entry, with a mean score on the 24-h average pain score (0–10) using the average of daily ratings from visit 1 to visit 2 | Antidepressant | Antidepressant= 62.1 ± 9.6 | American College of Rheumatology clinical criteria | Excluded patients with previous invasive knee surgery, arthroscopy and joint replacement | Knee Pain: Weekly 24-h worst pain; WOMAC pain subscale | Depression: Beck Depression Inventory-II | 9* |
(USA, 2009) | (intervention)= 111 (63.1%) | |||||||
Placebo= | ||||||||
Placebo Control | 62.5 ± 9.3 | |||||||
120 (67.5%) | Hospital | |||||||
Severity: BPI-S, Brief Pain Inventory-Severity; CGI-S, Clinical Global Impressions of Severity | Anxiety and Depression Scale (HADS) | |||||||
Abou-Raya | Aged 65 years and above attending the outpatient clinic | Antidepressant | Antidepressant= 68.9 ± 6.2 | American College of Rheumatology clinical criteria Radiographic criteria K/L grade I–III | NA | Knee Pain: Visual analogue pain scale | Depression: Geriatric depression scale | 10* |
(Egypt, 2012) | (intervention)= 144 (84%) | |||||||
Placebo= 68.5 ± 5.8 | ||||||||
Placebo Control 144 (84%) | WOMAC pain score | |||||||