Depression Worsens Quality of Life in Rheumatoid Arthritis

Rheumatoid arthritis (RA) patients may suffer from worse quality of life if they have depression, according to new research.

This was a systematic review and meta-analysis. The study authors queried English and Chinese databases including PubMed, the Cochrane Library, Web of Science, and PsycIFNO and Wan Fang Database and Chinese National Knowledge Infrastructure, respectively, from inception through Sept. 30, 2019. Eligible studies were those analyzing how depression affects pain, disease activity, functional disability, and quality of life, per the Short Form-36 questionnaire (SF-36).

Seven eligible studies encompassing 1,078 total RA patients were included in the study. Patients with depression, compared to those without, had a significantly higher total Disease Activity Score in 28 joints (standardized mean difference [SMD]=0.47; 95% confidence interval [CI], 0.10-0.85; P=0.01). Patients with depression also had lower scores in all measured SF-36 dimensions: physical function, role physical function, emotional role function, vitality, mental health, social function, body pain, general health, physical component scale, and mental component scale. However, there were no significant between-group differences regarding pain (SMD=0.57; 95% CI, –0.03 to 1.17; P=0.06) and functional disability (SMD=0.48; 95% CI, –0.03 to 0.99; P=0.43).

The study was published in the International Journal of Rheumatic Diseases.

Mental Health in Arthritis Patients

Previous studies have analyzed mental health in arthritis patients. A report from the Centers for Disease Control and Prevention (CDC) found that adults with arthritis are more likely to have anxiety than depression, but depression is more likely to be treated. Of adults aged ≥ 18 years who have arthritis, 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.

More adults with arthritis take medications to treat symptoms of 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).