The Prevalence of Anxiety in Patients With Beta-Thalassaemia Major: A Systematic Review and Meta-Analysis.

Most included studies were cross-sectional, so the review cannot show that beta-thalassaemia major caused anxiety or that anxiety came before or after disease stressors. The included studies varied widely in country, population and measurement method, so the pooled 33.0% estimate should not be treated as a fixed rate for every patient group. Most studies used self-report screening questionnaires rather than psychiatric interviews, so the result reflects anxiety symptoms or probable anxiety, not confirmed anxiety disorders. The review could not analyse children, adolescents and adults separately, or male and female patients separately, because the primary studies reported demographics inconsistently. Only published English-language literature was searched, and funnel plot asymmetry suggested possible publication bias. Patients attending thalassaemia clinics may be more resilient or better supported, which could underestimate anxiety in people who do not attend. The very high between-study variation and the use of different anxiety instruments limit confidence in any single summary prevalence number.

No funding was reported, and the authors declared no conflicts of interest.

Do not conclude that 33.0% of patients with beta-thalassaemia major have a diagnosed anxiety disorder. The pooled estimate came mainly from screening questionnaires, and the studies varied widely, so a positive screen means further clinical assessment is needed, not a confirmed diagnosis.