Are we missing the diagnosis of depression in patients with rheumatoid arthritis at a tertiary care facility?

Masood, Ammara; Salim, Babur; Nasim, Amjad; Khalid, Ziaullah; Afzal, Amir

doi:10.12669/pjms.332.11856

Cited by 14 publications

(7 citation statements)

References 26 publications

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“…Having difficulty performing functional tasks was associated with a higher occurrence of depressive symptoms amongst Chinese middle aged and older adults 55 and in a Pakistani study. 56 In this study, the majority of patients had functional impairment, with the bivariate analysis suggesting that their functional level was associated with depressive scores similar to other studies. 17 , 18 However, it was not significant on logistic regression, indicating the need to further explore this in a larger study.…”

Section: Discussionsupporting

confidence: 87%

Prevalence of depressive symptoms in patients with rheumatoid arthritis at a regional hospital in KwaZulu-Natal, South Africa

et al. 2022

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Background: Depression affects 14.8% – 38.8% of patients with rheumatoid arthritis (RA) in developed countries. The prevalence and risk factors for depression in patients with RA in sub-Saharan Africa is not well established.Aim: To determine the prevalence of depressive symptoms in patients with RA.Setting: Public sector regional hospital in South Africa.Methods: A cross-sectional descriptive study was undertaken with 110 adult RA patients. A structured socio-demographic and clinical questionnaire, the modified health assessment questionnaire (mHAQ), the simplified disease activity index (SDAI) for RA, the patient health questionnaire (PHQ-9), and the Household Food Insecurity Access scale (HFIAS) for nutritional status, were used. Correlates of depressive symptomatology in participants with RA were identified using t-tests and regression analyses.Results: Most of the participants were women (90.9%), 67% had moderate to severe RA disease on the SDAI score, 92.7% reported functional disability (HAQ score of ≥ 1), and 87.2% reported mild to severe depressive symptoms. Unemployment (p 0.01), severe food insecurity (p 0.01) and functional disability (p = 0.02), were significantly associated with the depressive symptoms, but not with disease activity (p = 0.8) or inflammatory markers (p = 0.63). Unemployment (adjusted β = −5.07, p 0.01) and severe food insecurity (adjusted β = −4.47, p 0.01) were significantly associated with depressive symptoms, based on the adjusted regression model.Conclusion: As RA effects functional status, with the impact of the resulting unemployment and food insecurity being associated with depression, affected people should be screened for depression and managed using a multidisciplinary approach, especially considering the role of social determinants in RA patients with depression.

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Section: Discussionsupporting

confidence: 87%

Prevalence of depressive symptoms in patients with rheumatoid arthritis at a regional hospital in KwaZulu-Natal, South Africa

et al. 2022

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“…In a study from Pakistan the diagnosis of clinical depression was missed in 47% of patients with RA who had been under regular follow-up at a tertiary care hospital. Only 18% of those diagnosed with depression were willing to seek referral to a psychiatrist for management of depression [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

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

Singh¹,

Mahajan²,

Abrol³

et al. 2021

Reumatologia

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Objectives: We planned this study to assess the prevalence of anxiety and depression in rheumatoid arthritis (RA) patients and its correlation with quality of life (QOL) in these patients. Material and methods: Eighty-eight patients (76 females) were included in this cross-sectional study. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression. Quality of life was measured using the World Health Organization WHOQOL-BREF. The severity of pain was measured by 100-millimetre-long Visual Analogue Scale (VAS), and functional disability was measured by using the Indian version of the Health Assessment Questionnaire (HAQ). The disease activity was measured by Disease Activity Score for 28 joints with 3 variables. Results: Probable anxiety and depression were seen in 61 (69%) and 68 (77%) of the patients, respectively. Patients with anxiety had more severe pain (VAS 53.8 ±26.4 vs. 39.7 ±26.1, p < 0.05), and significantly lower scores in all the 4 domains of the WHOQOL-BREF. Patients with depression had more pain (VAS 54.2 ±25.2 vs. 33.5 ±27.3, p < 0.01), higher HAQ scores (1.0 ±0.7 vs. 0.5 ±0.7, p < 0.01), and lower QOL scores. Both anxiety and depression scores had a negative correlation with all the 4 domains of the WHOQOL-BREF. Anxiety had a significant negative effect on psychological (β = -0.58, p < 0.001) and environmental domains (β = -0.39, p < 0.001), while depression had a significant negative effect on psychological (β = -0.57, p < 0.001) and environmental domains (β = -0.53, p < 0.001). Both anxiety and depression predicted more pain in RA patients (β = 0.24, p < 0.001 and β = 0.44, p < 0.001, respectively). Conclusions: Anxiety and depression correlated with poor QOL in all 4 domains of the WHOQOL-BREF. Higher HADS scores had a negative effect on all the domains of the WHOQOL-BREF and predicted more severe pain in RA patients. Thus, patients with RA need to be screened and treated for underlying anxiety and depression to improve their QOL, pain, and functional status.

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“…RA is a chronic inflammatory rheumatism with an impact on several components of the patient's health. Yet nearly half of patients with RA, and followed up in a 3rd level structure, have depression that has never been diagnosed and managed [6]. Recently in China, Fux et al in a meta-analysis that included 21 studies and 4447 RA patients found a prevalence of 48% depression [5].…”

Section: Discussionmentioning

confidence: 99%

“…Its clinical and serological feature is similar to those of RA Caucasian patients except for the rarity of rheumatoid nodules [4]. The prevalence of depression ranges from 16.8% to 63.6% in RA according to diagnostic tools [5] [6] [7] [8]. RA and depression are two diseases that have an intricate relationship with reciprocal influences and even some commonalities.…”

Section: Introductionmentioning

confidence: 99%

Frequency and Factors Associated with Depression in Rheumatoid Arthritis in African Black Patients: Case-Control Study

Zabsonré¹,

Kaboré²,

Nanema³

et al. 2019

OJRA

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Objective: To study the frequency and factors associated with depression in rheumatoid arthritis (RA) among Black African patients. Patients and methods: It was a case-control study with a group of patients with RA (case) and a group of healthy subjects without rheumatoid arthritis (controls) matched by age and sex. All patients admitted to the rheumatologic department during February 2015 to July 2015 for rheumatoid arthritis meeting the criteria ACR/EULAR 2010, were included. Patients with high blood pressure, diabetes mellitus, renal failure or HIV infection have been excluded. Depression was assessed by the Hamilton Rating Scale for Depression. Results: Fifty patients with RA were included and compared to 100 healthy controls. For RA patients, it was 39 (78%) female and 11 (22%) male with a sex ratio of 0.28. In the control group, it was 77 (77%) female and 23 (23%) male with a sex ratio of 0.29. Twenty-seven (54%) patients with RA had depression compared with 17 (17%) subjects in the control group (p = 0.000). Impaired quality of life and a DAS 28 score greater than 3.2 were statistically associated with depression during RA with a p value respectively of 0.021 and 0.0000231. Conclusion: Depression is significantly more common during RA than in non-RA controls. RA patients should be screened routinely for depression in order to ensure improved treatment and management.

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Are we missing the diagnosis of depression in patients with rheumatoid arthritis at a tertiary care facility?

Cited by 14 publications

References 26 publications

Prevalence of depressive symptoms in patients with rheumatoid arthritis at a regional hospital in KwaZulu-Natal, South Africa

Prevalence of depressive symptoms in patients with rheumatoid arthritis at a regional hospital in KwaZulu-Natal, South Africa

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

Frequency and Factors Associated with Depression in Rheumatoid Arthritis in African Black Patients: Case-Control Study

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