Abstract
Background
Psychological symptoms are frequently associated with chronic medical conditions and can harm the treatment and recovery from these illnesses. Depression and anxiety may be under-detected and under-treated in primary care and outpatient settings and have the potential to negatively impact adherence, functioning, quality of life, and disease outcomes.
Objective
This systematic review and meta-analysis aimed to provide an estimate of the prevalence of depression and anxiety among adults with chronic medical conditions who are cared for in primary and outpatient clinical care.
Methods
The review was done according to the PRISMA 2020 guidelines. The databases of PubMed/MEDLINE, Scopus, Web of Science, PsycINFO, and Google Scholar were searched from their inception to December 2025. Observational studies that reported depression and/or anxiety prevalence in adults with chronic medical disorders in primary care or outpatient settings were included. Random-effects meta-analyses were conducted to calculate pooled prevalence, and heterogeneity was explored by looking at I² statistics and prediction intervals.
Result
Forty studies were used for qualitative synthesis. In the case of depression, 12 studies provided data with 6,737 participants, of whom 1,702 were depressed. The pooled prevalence of depression was 30.2% (95% CI: 22.2%–39.6%; I² = 98.0%; prediction interval: 7.6%–69.4%). Five studies provided data for anxiety (4,146 participants with 1,314 cases). The pooled prevalence of anxiety was 31.3% (95% CI: 26.3%–36.8%; I² = 89.5%; prediction interval: 17.1%–50.2%).
Conclusion
A significant number of adults with chronic medical conditions have depression and/or anxiety in primary care and outpatient care. The results confirm the benefits of including routine mental health screening in chronic disease care. The pooled estimates should be viewed as summary estimates, as there is high heterogeneity.