Depression and the risk of rheumatoid arthritis

Abstract

Purpose of review Rheumatoid arthritis (RA) is associated with negative changes in mental health. This is generally attributed to symptoms of inflammation and the adverse impact of RA on quality of life and functioning. Until recently, causal pathways in the opposite direction have not been fully appreciated. This review examines the recent literature on the risk of RA associated with depression. Recent findings Current literature links depression with an increased risk of RA and with a more detrimental disease course. These effects are likely to be partially mediated by negative effects of depression on coping with RA and on factors such as medication adherence, both of which lead to poorer disease outcomes. Growing evidence also suggests that inflammation is central both to depression and RA and may account for some of the complex interplay between these conditions. Summary Awareness of a bidirectional relationship between depression and RA through a biopsychosocial framework may assist clinicians in maintaining an appropriate index of suspicion about the co-occurrence of these conditions. This review also suggests an important need for integration of rheumatologic and mental health services and generates hypotheses for future research towards a better understanding of both depression and RA.

Depression: a common comorbidity in women with rheumatoid arthritis—results from an Austrian cross-sectional study

“…Getting more and more insights into the reciprocity between depression and RA, current literature links depression with an increased risk for RA 18. A recent retrospective population-based cohort study covering data for 26 years, from 1986 to 2012, identified that depression even increases the risk for developing RA by 38%.…”

Incidence and risk factors of depressive symptoms in 4 years of follow-up among mid-aged and elderly community-dwelling Chinese adults: findings from the China Health and Retirement Longitudinal Study

“…In a population-based cohort in Taiwan, patients with rheumatoid arthritis were 2.06 times more likely to develop depression compared with the control patients 47. The high prevalence and incidence of depression among patients with arthritis may be attributed to several factors, including the impact of the diagnosis with no cure, arthritis symptoms and flare-ups, loss of work productivity and side effects of medications 48. In the current study, we found that chronic digestive disorders at baseline conferred a higher risk for depressive symptoms over time.…”

“…Potential participants with serious depressive symptoms should be referred immediately to a mental health professional. Individuals with these chronic conditions are particularly vulnerable to the deleterious effects of affective symptoms, since symptoms of depression are a known risk factor for non-compliance with medical treatment and adverse health outcomes 48 49 57 58…”

Health status and self‐management in patients with inflammatory arthritis—A five‐year follow‐up study after nurse‐led patient education

“…They also perceive that support from others with similar experiences is uniquely valuable (Hughes et al, ). However, patients with IA have a higher predisposition to develop depression or psychological distress (Howells et al, ; Vallerand, Patten, & Barnabe, ). Depression increases the risk of disease flares; decrease rates of remission and interferes with patients' coping strategies, clinical management (e.g.…”

“…Depression increases the risk of disease flares; decrease rates of remission and interferes with patients' coping strategies, clinical management (e.g. medication compliance) and quality of life (Vallerand et al, ). In the opposite case, patients with less depressed mood and dissatisfaction with life have higher levels of self‐efficacy and role balance (Coty, Salt, Myers, & Abusalem, ).…”