For Arthritis Patients, Depressive Symptoms May Affect Employment Participation

Depression is known to worsen quality of life in patients with rheumatoid arthritis. A new study also observed that depressive symptoms in arthritis patients may be negatively correlated with employment participation.

The study was performed using data from the U.S. National Health Interview Survey from 2013 through 2017. Patients with an arthritis diagnosis aged between 18 and 64 years who had complete data on self-reported depressive symptoms were included. Sociodemographic, health, and health system use variables were used as covariates. The relationship between employment prevalence and depressive symptoms was examined. Patients were stratified into three age groups: young (18-34 years), middle (35-54 years), and older adults (55-64 years).

Final analysis included 11,380 working-age adults with arthritis. The overall prevalence of depressive symptoms was 13%. Patients with depressive symptoms, versus those without, were more likely to have fair/poor health (60% vs. 23%) and activity limitations due to their arthritis (70% vs. 39%).

“Respondents with depressive symptoms reported significantly lower employment prevalence (30%) when compared with those not reporting depressive symptoms (66%) and lower multivariable‐adjusted association with employment (PR=0.88, 95% CI [confidence interval] 0.83‐0.93),” the authors reported.

When assessing data by age, middle-age adults with depressive symptoms, compared to patients in the same age group without depressive symptoms, were much less likely to be employed (PR, 0.88; 95% CI, 0.77 to 0.90), with similar outcomes observed for the younger (PR, 0.86; 95% CI 0.74 to 0.99) and older adults (PR, 0.94; 95% CI, 0.86 to 1.03).

The study was published in Arthritis Care & Research.

“For adults with arthritis, depressive symptoms are associated with not participating in employment. Strategies to reduce arthritis‐related work disability may be more effective if they simultaneously address mental health,” the study authors wrote in their conclusion.

Previous research found that while anxiety is more common than depression among arthritis patients, they are more likely to be treated for the latter.

In this study, among patients with arthritis and chronic pain, 18.7% said they had depressive symptoms. Anxiety and depressive symptom prevalence was higher among those with co-occurring chronic conditions, psychological distress, and poor self-rated health. Cigarette smokers were more likely to report symptoms than those who had never smoked. Self-reported physical activity was associated with a decrease in symptom prevalence.

The report, published by the Centers for Disease Control and Prevention, concluded, “Health care providers can help their arthritis patients by screening and considering treating or referring adults with symptoms to mental health professionals or self-management education programs, and encouraging physical activity, which is an effective nonpharmacologic strategy that can help reduce the symptoms of anxiety and depression, improve arthritis symptoms, and promote better quality of life.”