Are depression and anxiety associated with disease activity in rheumatoid arthritis? A prospective study (original) (raw)
Related papers
The Journal of rheumatology, 2002
Heightened levels of anxiety and depressed mood are known to be common consequences of rheumatoid arthritis (RA). We examined the role of stress vulnerability factors in the longterm course of anxiety and depressed mood in patients with early RA. Specifically, the role of personality characteristics (neuroticism, extraversion), physical and psychological stressors (clinical status, disease influence on daily life, major life events), and coping and social support at the time of diagnosis were studied to predict changes in anxiety and depressed mood 3 and 5 years later. Anxiety and depressed mood, predicted from clinical and self-reported assessments of stress vulnerability factors at the time of diagnosis in 78 patients with RA were assessed again after 3 and 5 years. A worse clinical status, more neuroticism, and lower education level at the time of diagnosis were all significantly related to increased psychological distress at the 3 and 5 year followup. However, the personality ch...
BMC Psychiatry, 2012
Background: While it is recognised that depression is prevalent in Rheumatoid Arthritis (RA), recent studies have also highlighted significant levels of anxiety in RA patients. This study compared two commonly used scales, the Depression Anxiety and Stress Scale (DASS) and the Hospital Anxiety and Depression Scale (HADS), in relation to their measurement range and cut points to consider the relative prevalence of both constructs, and if prevalence rates may be due to scale-specific case definition. Methods: Patients meeting the criteria for RA were recruited in Leeds, UK and Sydney, Australia and asked to complete a survey that included both scales. The data was analysed using the Rasch measurement model. Results: A total of 169 RA patients were assessed, with a repeat subsample, resulting in 323 cases for analysis. Both scales met Rasch model expectations. Using the 'possible+probable' cut point from the HADS, 58.3% had neither anxiety nor depression; 13.5% had anxiety only; 6.4% depression only and 21.8% had both 'possible+probable' anxiety and depression. Cut points for depression were comparable across the two scales while a lower cut point for anxiety in the DASS was required to equate prevalence. Conclusions: This study provides further support for high prevalence of depression and anxiety in RA. It also shows that while these two scales provide a good indication of possible depression and anxiety, the estimates of prevalence so derived could vary, particularly for anxiety. These findings are discussed in terms of comparisons across studies and selection of scales for clinical use.
Anxiety, Depression and Stress in Patients with Rheumatoid Arthritis
Procedia - Social and Behavioral Sciences, 2016
Problem Statement: Rheumatic diseases carries a high physical, psychological and social impact, with relevant multi-dimensional assessment of psychosocial functioning of these rheumatic patients, reasons for carrying out the present study. Research Questions: What is the prevalence of anxiety, depression and stress in patients with rheumatoid arthritis? Purpose of the Study: This aimed to identify the prevalence of anxiety, depression and stress in people with rheumatoid arthritis These have in our population worse quality of life indicators, when compared with the general population. Research Methods: The study observational was conducted with 80 participants, 82.5% were female, aged between 21 and 80 years, with an average of 58.16 years.
Clinical Rheumatology, 2020
Objectives In people with rheumatoid arthritis (RA), mental health problems are common, but often not recognized or treated, contributing to increased morbidity and mortality. Most studies examining the impact of mental health problems in RA have focused on depression. We aimed to determine the association between anxiety, and disease activity and quality of life (QoL) in people with RA. Methods A systematic review and meta-analysis were performed. A protocol was registered with PROSPERO (CRD2-17062580). Databases (Web of Science, PsycINFO, CINAHL, Embase, Medline) were searched for studies examining the association between anxiety and disease activity and QoL, in adults with RA, from inception to February 2019. Primary outcome measures were DAS28 and SF-36. Eligibility screening and data extraction were completed by two reviewers. Disagreements were resolved by discussion or a third reviewer. Quality assessment was carried out using the Newcastle-Ottawa Scale. Results From 7712 unique citations, 60 articles were assessed for eligibility. The final review included 20 studies involving 7452 people with RA (14 cross-sectional, 6 cohort). Eleven examined disease activity, 6 reported QoL outcome measures and 3 included both. Anxiety was associated with increased disease activity and worse QoL. Meta-analysis showed anxiety to be correlated with increased DAS28 scores (r = 0.23, CI 0.14, 0.31) and reduced physical (r = − 0.39, CI − 0.57, − 0.20) and mental QoL (− 0.50, CI − 0.57, − 0.43). Conclusions Anxiety in people with RA is associated with increased disease activity and worse QoL. Improved recognition and management of comorbid anxiety may help to improve outcomes for people with RA. Key Points • This is the first systematic review and meta-analysis to examine the relationship between anxiety and disease activity and QoL in people with RA. • Anxiety was associated with higher disease activity both cross-sectionally and at up to 12-month follow-up. • Anxiety may have a more significant impact on disease activity in early RA, highlighting the importance of early recognition and management of comorbid anxiety. • People with anxiety had poorer self-reported physical and mental QoL, although there was some heterogeneity in study findings, particularly for physical QoL (I 2 = 78.5%).
Is anxiety a more common disorder than depression in rheumatoid arthritis?
Joint Bone Spine, 2002
Objective. As most of the previous studies were done to study depressive disorders and /or symptoms in patients with rheumatoid arthritis, this study was performed to investigate whether anxiety disorder is as common as depressive disorder in these patients and to look for the socio-demographic as well as the clinical characteristics of the patients developing these disorders. Methods. A detailed physical assessment of 80 patients with rheumatoid arthritis was performed. Also psychiatric assessment was done using Research Diagnostic Criteria for the International Classification of Diseases-10 (ICD-10). In addition, patients answered a Health Assessment Questionnaire (HAQ) to assess their functional capacity. Results. Depression was diagnosed in 66.2% of the total sample while anxiety was diagnosed in 70%. Functional disability, social stress and morning stiffness were the factors highly associated with depression. Using multiple regression analysis, anxiety was highly associated with depression as well as Ritchie articular index. Conclusion. Psychiatric illness is a relatively common disorder in patients with RA, with a frequency higher than that of other general medical conditions. Anxiety is a more common disorder than depression. The first step in correct management is recognition of anxiety and depression so that appropriate treatment can be tried. Particular attention has to be paid to social stress and lack of social support.
Aim of the work: To assess the effect of clinical manifestations, disease activity and medications on health-related quality of life (HRQoL) among patients with early rheumatoid arthritis (RA). Patients and methods: Twenty-six early RA patients (mean age 43.31 ± 10.51 years, disease duration: 16.5 ± 5.2 months) diagnosed according to the 2010 RA classification criteria were recruited from the outpatient clinic of the Rheumatology and Rehabilitation Department, Sohag University, and 22 age and sex matched healthy persons participated in a case control study. Demographic data were taken from all participants in the study. The 36-item short-form health survey (SF-36) and Ham-ilton Anxiety Rating Scale (HAM-A) were assessed as measures of HRQoL and psychiatric comorbid-ity for both patients and controls. Disease activity in RA was assessed using the disease activity score (DAS28). Scoring algorithms were applied to produce the physical and mental component scores (PCS and MCS). Results: There was statistically significant difference in the total SF36 score, anxiety and depression scores of HAM-A scale between patients and controls. The PCS showed the highest significant difference (p < 0.0001), followed by SF36 (p = 0.01) and MCS (p = 0.024). There were no significant differences according to the age, gender, occupation or level of education of the patients. Anxiety and depression scores significantly correlated with the bodily pain and DAS28 scores and inversely with the
2014
A growing amount of literature has explored mainly the role of depression (and/or anxiety) in patients with rheumatic disorders. We aimed at determining the prevalence of depression, anxiety, and their association with quality of life among patients attending a rheumatology clinic, focusing on data regarding concomitant psychiatric treatment. Depression, anxiety, and quality of life were assessed using the Zung Self-Rating Depression Scale, the Hamilton Anxiety Scale, and the Health Assessment Questionnaire, respectively. Overall, 514 rheumatologic patients were studied. Depression and anxiety were documented in 21.8 and 30.8 % of the population, respectively, and correlated significantly with quality of life. Only 13.4 % of patients with depressive symptoms and 12.1 % of patients with anxiety symptoms were receiving antidepressant or antianxiety medication. Given the wide therapeutic armamentarium available nowadays for the management of depression and anxiety, an increased awareness among physicians dealing with rheumatologic patients is warranted in order to integrate detection and effective treatment of anxiety and depression into the routine clinical practice. Special attention should be paid to female patients, patients with longer disease duration, and/or those with established disability.
The Journal of Rheumatology, 2014
Objective.To investigate the effect of depression, anxiety, fatigue, and fibromyalgia (FM) on the remission status in patients with rheumatoid arthritis (RA), defined according to the 28-joint count Disease Activity Score (DAS28)-erythrocyte sedimentation rate (ESR) and the Boolean-based new American College of Rheumatology/European League Against Rheumatism remission criteria.Methods.The subjects were patients with RA who participated in a hospital-based observational cohort. Patients who met the DAS28-ESR remission criteria at their latest visit were invited to participate in our study. The patient groups fulfilling or not fulfilling the Boolean remission criteria were identified and compared with each other with regard to the presence of depression, anxiety, fatigue (0–50), and FM. The relationship between psychosocial factors and Simplified Disease Activity Index (SDAI) remission, which is the index-based definition of remission in RA, was also investigated.Results.A total of 87...
2017
Background: Psychiatric disorders occur in a considerable proportion of patients with rheumatoid arthritis (RA), often reflecting the difficulties of these patients in coping with a chronic debilitating disorder. Aim of the study: We aimed to study Evaluation of depression and its correlation with anxiety symptoms, quality of life index and duration of disease in patients with rheumatoid arthritis. Methods: Patients were defined as having RA and depression when there was at least one documented diagnosis identified by the International Classification of Diseases-10 (ICD-10) from the medical records. The proportion of depression was compared between RA patients and controls. A logistic regression model was used to estimate the association between RA and depression, anxiety disorder, quality of life index and duration of disease in a multivariate analysis adjusted for age, gender and socioeconomic status. Results: The study included 120 patients with RA and 40 people without mental and somatic pathology. Depression in RA patients included mild depressive disorders (GA-37.74%, GB-4.48%), anxiety-depressive disorders (GA-28.30% GB-41.79%), depressive-hypochondriac disorders (GA-3.77%, GB-20.90%). In multivariate analysis, RA was found to be independently associated with depression and anxiety. Conclusion: Our study confirms the higher proportion of depression in RA patients: especially young women with average socioeconomic status (mild depressive disorders); old women with low socioeconomic status (depressive-hypochondriac disorders). The impairment of quality of life is markedly in patient with depressive-hypochondriac disorders. Physicians should be aware of such findings and, therefore, apply proper screening strategies.