RA Patients More Susceptible to Anxiety

Patients with rheumatoid arthritis (RA) may have an increased risk for anxiety, according to a meta-analysis.

“Rheumatoid arthritis (RA) may increase the risk of anxiety, but results from prior studies have no consensus. Our study aimed to evaluate the relationship between RA and incident anxiety by using a quantitative meta-analysis,” the researchers wrote. Their study was published in the August issue of Clinical Rheumatology.

The researchers queried several databases, including PubMed, EMBASE, and Web of Science. Articles published through July 23, 2018, were included, and researchers used an odds ratio (OR) with 95% confidence interval (CI) to determine the association. “The random-effects model played a crucial role in calculating the pooled odds ratio, while subgroup analyses and sensitivity analyses were also performed,” wrote the authors.

The final analysis included 10 studies encompassing 139,875 patients and 6,201 cases of anxiety. All patients did not have anxiety at baseline. Follow-up spanned from one year to 9.2 years.

“Overall, the quantitative meta-analysis suggested that subjects with RA were associated with a significantly increased risk of anxiety incidence (OR, 1.20; 95% CI, 1.03–1.39) than those without,” the researchers found.

Based on their findings, the authors concluded that RA patients may be more likely to develop anxiety. They recommended that, looking ahead, studies should “explore whether clinical manifestations of RA are modifiable risk factors for anxiety.”

Mental Illness in Arthritis Patients

Previous research has established a link between arthritis and mental illness. The subject was the theme of a 2018 report published by the Centers for Disease Control and Prevention (CDC).

According to the report, among arthritis patients aged ≥ 18 years, anxiety was reported in 22.5% (95% confidence interval [CI] = 20.8–24.3) and depression in 12.1% (CI = 10.8–13.4)—compared to 10.7% (CI = 10.2–11.2) and 4.7% (CI = 4.4–5.0), respectively, among adults without arthritis. Patients with arthritis and chronic pain had an even greater prevalence of symptoms of anxiety (31.2%) and depression (18.7%). Symptom prevalence was associated with co-occurring chronic conditions, psychological distress, and poor self-rated health. Compared to never smokers, cigarette smokers were more likely to report symptoms. Physical activity was associated with a decreased risk in symptom reporting, and patients aged between 18 and 64 years were more likely to report symptoms than older patients.

Despite the significantly higher prevalence of anxiety than depression, the CDC reported that arthritis patients are more likely to take medication for depression than anxiety (57.7% [CI = 52.4–62.9] vs. 44.3% [CI = 40.4–48.3], respectively). Patients with depressive symptoms were also more likely to report having spoken with a mental health professional in the past year than those with anxiety (42.8% [CI = 37.7–48.1] vs 34.3% [CI = 30.3–38.1], respectively).

The report 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.”