Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms

Abstract

Background To describe demographic and clinical factors associated with the prevalence and incidence of depression and explore the temporal relationship between depression and joint symptoms in patients with symptomatic knee osteoarthritis (OA). Methods 413 participants were selected from a randomized controlled trial in people with symptomatic knee OA and vitamin D deficiency (age 63.2 ± 7.0 year, 50.4% female). Depression severity and knee joint symptoms were assessed using the patient health questionnaire (PHQ-9) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively, at baseline and 24 months. Results The prevalence and incidence of depression was 25.4% and 11.2%, respectively. At baseline, having a higher body mass index (BMI), greater scores of WOMAC pain (PR: 1.05, 95%CI:1.03, 1.07), dysfunction (PR: 1.02, 95%CI:1.01, 1.02) and stiffness (PR: 1.05, 95%CI: 1.02, 1.09), lower education level, having more than one comorbidity and having two or more painful body sites were significantly associated with a higher prevalence of depression. Over 24 months, being female, having a higher WOMAC pain (RR: 1.04, 95%CI: 1.00, 1.08) and dysfunction score (RR: 1.01, 95%CI: 1.00, 1.02) at baseline and having two or more painful sites were significantly associated with a higher incidence of depression. In contrast, baseline depression was not associated with changes in knee joint symptoms over 24 months. Conclusion Knee OA risk factors and joint symptoms, along with co-existing multi-site pain are associated with the prevalence and development of depression. This suggests that managing common OA risk factors and joint symptoms could be important for prevention and treatment depression in patients with knee OA.

Non-invasive brain stimulation for osteoarthritis

“…10.3389/fnagi.2022.987732 (Zheng et al, 2021), and the long-term accumulation of these symptoms may aggravate the pain grade and joint dysfunction of patients with OA (Rathbun et al, 2018(Rathbun et al, , 2020. NIBS has been widely used in research related to depressive symptoms.…”

Factors associated with subjective knee joint stiffness in people with knee osteoarthritis: A systematic review

“…Study participants were recruited from the USA, [11][12][13][14] the UK, [15][16][17][18][19] Australia, [20][21][22] the Netherlands, 23,24 Belgium, 25,26 Spain, 27,28 Canada, 29 and three Nordic countries. 30 The sample sizes in the selected studies ranged from 32 29 to 2589 15,19 participants.…”

“…Nine studies were single cohort studies 18,22-28,30 and 11 were multiple cohort studies. [11][12][13][14][15][16][17][19][20][21]29 All studies included in this systematic review measured subjective knee stiffness using the WOMAC.…”

Singapore KneE osTeoarthritis CoHort (SKETCH): protocol for a multi-centre prospective cohort study

“…Prolonged pain experiences can lead to negative psychological outcomes, and vice versa. A recent longitudinal study found that greater perceived OA pain and dysfunction at baseline is found to be associated with a higher incidence of depression at follow up [18]. Systematic review-level evidence has also identified that anxiety and depression symptoms in patients with OA are associated with poor healthcare outcomes, including increased doctor visits, healthcare utilisation, medication prescription, poor surgical outcomes and post-surgical pain [14].…”