Anxiety and depression are common in rheumatoid arthritis and correlate with poor quality of life in Indian patients

Singh, Gurmeet; Mahajan, Nikhil; Abrol, Sameer; Raina, Abhinav

doi:10.5114/reum.2021.112351

Cited by 10 publications

(10 citation statements)

References 28 publications

(48 reference statements)

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“…Several studies from Egypt, India, Iran, and China showed high depression and anxiety levels in RA patients. 11, 37 - 39 In a review study, Gettings 40 analyzed the RA-associated psychological impact and assumed that disease-related disabilities, pain during disease activity, and other social difficulties plausibly explain the high anxiety and depression levels in RA patients.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Depression and Anxiety in Rheumatoid Arthritis Patients During COVID-19 Pandemic

Abd EL-Khalik,

Eltohamy

2023

Clin Med�Insights�Arthritis�Musculoskelet Disord

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Background: Rheumatoid arthritis (RA) disease activity, associated comorbidities, and therapy-related side effects impair the physical, social, and emotional dimensions of the patient’s health. Presently, the ongoing COVID-19 pandemic has been associated with a broad range of psychosocial disorders in various populations. Patients with RA are especially vulnerable to such effects. Objectives: Detect the prevalence of recent COVID-19 infection among patients with RA, assess depression and anxiety in these patients and their associated factors during the COVID-19 pandemic and their potential relation to disease activity. Design and Methods: This is a cross-sectional study conducted on 120 adult Egyptian patients diagnosed with RA during the COVID-19 pandemic. The prevalence of recent COVID-19 infection among the patients was evaluated. The patients underwent psychological assessment using the Hamilton Depression Rating Scale (Ham-D) and the Hamilton Anxiety Rating Scale (Ham-A) to measure levels of depression and anxiety levels. The RA disease activity was assessed using Disease Activity Score (DAS) Das-28-ESR. Results: This study encompasses a total of 120 RA patients. The prevalence of patients with a recent history of COVID-19 infection was 40.8%. Both groups exhibited significantly elevated mean scores on the Das-28-ESR scale and also scored higher on measures of depression and anxiety. Interestingly, the COVID-19 group exhibited a higher percentage of unmarried individuals, had educational attainment below the university level, and were unemployed. Patients with recent COVID-19 had significantly lower numbers of children, higher disease duration, higher Das-28-ESR scores, and elevated depression and anxiety scores. The statistical analysis revealed that the COVID-19 infection and disease duration were significant predictors of depression and anxiety. The results also exhibited that the depression score was positively correlated with age and DAS scores. Conclusions: It was observed that patients diagnosed with RA revealed a higher prevalence of COVID-19 infection. The occurrence of depression and anxiety was observed to be widespread among patients diagnosed with RA and, more significantly, prevalent in RA patients who had a recent COVID-19 and had a higher level of disease activity. The occurrence of COVID-19 and disease duration were identified as factors that can anticipate the development of depression and anxiety.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Depression and Anxiety in Rheumatoid Arthritis Patients During COVID-19 Pandemic

Abd EL-Khalik,

Eltohamy

2023

Clin Med�Insights�Arthritis�Musculoskelet Disord

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“…In detail, RA patients have to face many obstacles during routine daily life owing to unbearable pain, joint deformity, fatigue, diet, etc. Owing to the incurability of RA, these RA patients are always under high psychological pressure, which vastly increases their risk of anxiety and depression [ 12 , 16 , 25 ]. The increased financial disbursement for anxiety and depression could, in turn, aggravate RA by reducing the expense for RA treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Previous papers have reported that anxiety and depression are highly prevalent in RA patients, indicating that the anxiety rate might even be as high as 69.6% and the depression rate as high as 14–58.3% [ 10–15 ]. Meanwhile, other studies have observed that anxiety or depression is related to pain degree, quality of life, and sleep disturbance in RA patients [ 16 , 17 ]. However, previous studies have applied only a single scale to evaluate anxiety and depression, and the independent risk factors related to their occurrence have seldom been investigated; moreover, the consistency between different scales in RA patients has also not been reported sufficiently.…”

Section: Introductionmentioning

confidence: 99%

Anxiety and depression in rheumatoid arthritis patients: prevalence, risk factors and consistency between the Hospital Anxiety and Depression Scale and Zung’s Self-rating Anxiety Scale/Depression Scale

Cheng,

Gao,

et al. 2023

Rheumatology Advances in Practice

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Objectives The current study intended to explore the prevalence and independent risk factors for anxiety and depression in rheumatoid arthritis (RA) patients and to assess the consistency between the hospital anxiety and depression scale (HADS) and Zung’s self-rating anxiety scale/depression scale (SAS/SDS). Methods In total, 160 RA patients and 60 healthy controls (HCs) were consecutively enrolled, and HADS and SAS/SDS scales were completed. Results The HADS-defined anxiety rate, HADS-defined depression rate, SAS-defined anxiety rate, and SDS-defined depression rate were 36.9%, 36.3%, 29.4%, and 29.4% in RA patients, which were all greatly higher in RA patients than in HCs (all p < 0.001). A relatively high consistency was observed between HADS-defined anxiety and SAS-defined anxiety (Kappa = 0.551, p < 0.001), as well as between HADS-defined depression and SDS-defined depression (Kappa = 0.563, p < 0.001) in RA patients. Interestingly, screened by multivariate logistic regression analyses, single/divorced/widowed marital status, swollen joint count, disease duration, erythrocyte sedimentation rate, physician's global assessment (PhGA), and 28-joint disease activity score (DAS28) were independently correlated with HADS-defined or SAS-defined anxiety risk in RA patients; meanwhile, female gender, single/divorced/widowed marital status, rural location, disease duration, PhGA, and DAS28 were independently associated with HADS-defined or SDS-defined depression risk in RA patients. Conclusion Anxiety and depression are highly prevalent in RA patients and are independently correlated with single/divorced/widowed marital status and higher disease activity. In addition, the HADS scale presents a high consistency with the SAS/SDS scale with many fewer questions, which may be more suitable for RA long-term assessment. Lay Summary What does this mean for patients? People with rheumatoid arthritis (RA) also frequently have mental health conditions such as anxiety and depression. We wanted to see what percentage of people with RA have mental health conditions, as well as which aspects of RA affect the occurrence of these mental health conditions. Finally, we wanted to compare two questionnaires used to diagnose mental health conditions—the hospital anxiety and depression scale and Zung’s self-rating anxiety scale/depressions scale. In this study, we investigated 160 people with RA and 60 healthy people. We found that mental health conditions are common in people with RA; between 29.4% and 36.9% of people in our study had anxiety, and between 29.4% and 36.3% had depression. These rates are higher than those seen in healthy people. Many factors could affect the occurrence of mental health conditions, including marital status, joint status, disease duration, and inflammation status. The two questionnaires used produced consistent results when evaluating patients’ mental health conditions. However, the hospital anxiety and depression scale has fewer questions and may therefore be more suitable for RA long-term assessment.

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“…However, there is substantial literature available concerning neuropsychiatric conditions and inflammatory diseases. RA has been associated with an increased risk of developing anxiety and major depressive disorder [268][269][270]. In SLE, neuropsychiatric symptoms have long been recognized in the American College of Rheumatology diagnostic guidelines [13].…”

Section: Neuropsychiatric Phenomena In the Context Of Chronic Periphe...mentioning

confidence: 99%

From Low-Grade Inflammation in Osteoarthritis to Neuropsychiatric Sequelae: A Narrative Review

Naumovs

Groma

Mednieks

2022

IJMS

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Nowadays, osteoarthritis (OA), a common, multifactorial musculoskeletal disease, is considered to have a low-grade inflammatory pathogenetic component. Lately, neuropsychiatric sequelae of the disease have gained recognition. However, a link between the peripheral inflammatory process of OA and the development of neuropsychiatric pathology is not completely understood. In this review, we provide a narrative that explores the development of neuropsychiatric disease in the presence of chronic peripheral low-grade inflammation with a focus on its signaling to the brain. We describe the development of a pro-inflammatory environment in the OA-affected joint. We discuss inflammation-signaling pathways that link the affected joint to the central nervous system, mainly using primary sensory afferents and blood circulation via circumventricular organs and cerebral endothelium. The review describes molecular and cellular changes in the brain, recognized in the presence of chronic peripheral inflammation. In addition, changes in the volume of gray matter and alterations of connectivity important for the assessment of the efficacy of treatment in OA are discussed in the given review. Finally, the narrative considers the importance of the use of neuropsychiatric diagnostic tools for a disease with an inflammatory component in the clinical setting.

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Anxiety and depression are common in rheumatoid arthritis and correlate with poor quality of life in Indian patients

Cited by 10 publications

References 28 publications

Evaluation of Depression and Anxiety in Rheumatoid Arthritis Patients During COVID-19 Pandemic

Evaluation of Depression and Anxiety in Rheumatoid Arthritis Patients During COVID-19 Pandemic

Anxiety and depression in rheumatoid arthritis patients: prevalence, risk factors and consistency between the Hospital Anxiety and Depression Scale and Zung’s Self-rating Anxiety Scale/Depression Scale

From Low-Grade Inflammation in Osteoarthritis to Neuropsychiatric Sequelae: A Narrative Review

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