Objective. Although there is a strong relationship between depression, chronic pain, and physical activity, there are few findings regarding the prevalence and predictors of depression in patients with osteoarthritis (OA). The goal of the present study was to assess the prevalence and severity of depression in a large sample of patients with OA and to reveal predictors of depression. Methods. Patients were approached consecutively in 75 general practices. Of 1,250 distributed questionnaires, 1,021 were returned and analyzed. Besides sociodemographic data, medication and comorbidities, depression, and arthritis were assessed using the Patient Health Questionnaire (PHQ-9) and the Arthritis Impact Measurement Scale. A stepwise multiple linear regression analysis with the PHQ-9 score as the dependent variable was performed. Results. On the PHQ-9, 19.76% of men and 19.16% of women achieved a score of >15, indicating at least a moderately severe depression. Significant sex differences could not be revealed. The strongest predictor for depression severity was perceived pain (␤ ‫؍‬ 0.243, P < 0.001) and few social contacts (␤ ‫؍‬ 0.218, P < 0.001). Further predictors were physical limitation of the lower body (␤ ‫؍‬ 0.157, P < 0.001) and upper body (␤ ‫؍‬ 0.163, P < 0.001), age (␤ ‫؍‬ ؊0.168, P < 0.001), and body mass index (␤ ‫؍‬ 0.080, P ‫؍‬ 0.020). Conclusion. These findings suggest an increased prevalence of depression among patients with OA and emphasize the need for recognition and appropriate treatment. Most of the revealed predictors are influenceable and should be potential targets in a comprehensive treatment of OA to interrupt the vicious circle of pain, physical limitation, and depression.

Paracetamol is the first choice mediation for osteoarthritis. The analgetic potential of NSAIDs is slightly higher and they also have some antiphlogistic effect, but their use has to be strictly limited to a short period of time. They should mainly be used in the therapy of the acute and painful phase of osteoarthritis. Among the NSAIDs, Diclofenac is the medication of first choice. In patients with an increased risk of gastrointestinal complications, a protonpumpinhibitor should be added. Patients with cardiovascular risk factors should receive NSAIDs only in case of no appropriate alternative treatments. Opioids have their place in osteoarthritis treatment and should be part of an individualized pain regime, which should also contain a pain diary and proactive monitoring. It is important to emphasize the positive effects of physical activity on the function of the joints as well as the negative effect of overweight and immobility.

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