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Table 4 Depression and anxiety

From: A systematic review and meta-analysis of risks and benefits with breast reduction in the public healthcare system: priorities for further research

Author
Year
Country
Study design Number of patients Withdrawals—dropouts Intervention
Breast reduction
Mean (SD)
Control
No surgery
Mean (SD)
P values of intergroup difference if not state otherwise
Comments Directness* Study limitations* Precision*
Beraldo
2016
Brazil [41]
RCT I: 30
C: 30
I: 1
C: 3
Depression score (BDI)
Baseline: 12.4 (9.0)
3 months: 10.2 (9.9)
6 months: 7.2 (9.9)
Intragroup change: Baseline to 3 and 6 months
p < 0.001
Depression score (BDI)
Baseline: 13.2 (9.6)
p = 0.89
3 months: 13.0 (8.5)
p = 0.12
6 months: 13.7 (10.5)
p = 0.01
Intragroup change: Baseline to 3 and 6 months
p = 0.89
Beck Depression Inventory (BDI) (21 items, range 0–63, higher score indicates worse depression)
 < 10 = no or minimal depression
10–16 = mild depression
17–29 = moderate depression
30–63 = severe depression
A MID of 17.5% of the total score (11 points) has been suggested for BDI [63]
? ? ?
Iwuagwu
2006
UK [39]
RCT I: 36
C: 37
0 Depression score
Baseline: 0.69 (0.30)
4 months: 0.39 (0.27)
Proportion depressed (no. (%)):
Baseline:
Normal score: 28 (78)
Borderline score: 6 (17)
Abnormal score: 2 (6)
4 months:
Normal score: 34 (94)
Borderline score: 1 (3)
Abnormal score: 1 (3)
Depression score
Baseline: 0.70 (0.29)
4 months: 0.79 (0.27)
p < 0.001
Proportion depressed (no. (%)):
Baseline:
Normal score: 27 (73)
Borderline score: 8 (22)
Abnormal score: 2 (6)
4 months:
Normal score: 25 (67)
Borderline score: 10 (27)
Abnormal score: 2 (6)
p < 0.001
Hospital Anxiety and Depression Scale (HADS) (7 items, range 0–21. Higher score indicates worse depression)
0–7 ‘normal’
8–10 ‘borderline’
 ≥ 11 ‘clinical depression/anxiety’
Depression scores were transformed to appropriate a Gaussian distribution (1 + log 10)
A MID of 1.7 has been suggested for HADS [64]
? ? ?
     Anxiety score
Baseline: 9.1 (3.9)
4 months: 5.0 (3.5)
Baseline: No (%)
Normal score: 12 (33)
Borderline score: 11 (31)
Abnormal score: 13 (36)
Anxiety score
Baseline: 9.1 (4.0)
4 months: 9.6 (3.8)
p < 0.001
Baseline: No (%)
Normal score: 12 (32)
Borderline score: 11 (30)
Abnormal score: 14 (38)
    
     4 months:
Normal score: 30 (83)
Borderline score: 4 (11)
Abnormal score: 2 (6)
4 months:
Normal score: 10 (28)
Borderline score: 10 (28)
Abnormal score: 17 (47)
p < 0.001
MD 4.6
    
Saariniemi
2009
Finland [57]
RCT I: 40
C: 42
I: 11
C: 7
RBDI
Depression
Baseline: 5 (2.5–6.5)
6 months: 0 (0.0–2.5)
Median (interquartile)
RBDI
Depression
Baseline: 4 (1.0–8.0)
6 months: 4 (0.0–7.0)
p < 0.01
Median (interquartile)
RBDI: Raitasalo’s modification of the short form of the Beck Depression inventory (range 0–39, lower better)
5–7: mild depression
8–15: moderate depression
 > 16: severe depression
?/ +  ?  + 
     Proportion depressed (no. (%)):
Baseline: 16 (55)
6 months: 2 (7)
Proportion depressed (no. (%)):
Baseline: 15 (43)
6 months: 15 (43)
p < 0.01
Proportions:
Depressed = RBDI depression score > 4
   
     Anxiety
No. (%)
Baseline: 18 (62)
6 months: 3 (10)
Anxiety
No. (%)
Baseline: 18 (51)
6 months: 12 (34)
p = 0.04
MD 9
    
  1. * + No or minor problems; ? Some problems; - Major problems
  2. BDI Beck Depression Inventory, HADS Hospital Anxiety and Depression Scale, RBDI Raitasalo’s modification of the short form of the Beck Depression Inventory