Do depression and anxiety reduce the likelihood of remission in rheumatoid arthritis and psoriatic arthritis? Data from the prospective multicentre NOR-DMARD study

Michelsen, Brigitte; Kristianslund, Eirik; Sexton, Joseph; Hammer, Hilde Berner; Fagerli, K.; Lie, Elisabeth; Wierød, Ada; Kalstad, Synøve; Rødevand, Erik; Krøll, Frode; Haugeberg, Glenn; Kvien, Tore K

doi:10.1136/annrheumdis-2017-211284

Cited by 184 publications

(153 citation statements)

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“…These effects were found to be more pronounced among adult psoriasis patients with pre‐adult onset, with age serving as a moderator of the effect of psoriasis on the degree of psychological impediment . The comorbidity of psoriasis with anxiety and depression was found to affect treatment response, as higher scores of anxiety or depression among psoriasis patients were found to reduce the likelihood of remission after 3 and 6 months of treatment . These results have been summarized recently in a narrative review exploring epidemiological, observational and clinical studies, indicating a substantially greater mental health comorbidity burden in patients with psoriasis compared to those without psoriasis or patients with other dermatologic conditions …”

Section: Introductionmentioning

confidence: 95%

“…5 The comorbidity of psoriasis with anxiety and depression was found to affect treatment response, as higher scores of anxiety or depression among psoriasis patients were found to reduce the likelihood of remission after 3 and 6 months of treatment. 6 These results have been summarized recently in a narrative review exploring epidemiological, observational and clinical studies, indicating a substantially greater mental health comorbidity burden in patients with psoriasis compared to those without psoriasis or patients with other dermatologic conditions. 7 While studies assessing anxiety and depression disorders among patients with psoriasis have focused on determining the unique prevalence of each disorder separately, fewer have addressed the prevalence of their joint presentation.…”

Section: Introductionmentioning

confidence: 99%

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The association between the socioeconomic status and anxiety–depression comorbidity in patients with psoriasis: a nationwide population‐based study

Bitan

Krieger

Comaneshter

et al. 2019

Acad Dermatol Venereol

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Background Numerous studies have indicated that comorbid anxiety and depression are associated with a more severe course of illness. Yet generally, the study of the effect of psoriasis on patients’ mental health has considered anxiety and depression to be separate states. Objective To measure the association between psoriasis and anxiety, depression and anxiety–depression co‐occurrence among patients according to their socioeconomic statuses (SES). Methods A nationwide population‐based study of psoriasis patients and age and gender frequency‐matched controls (n = 255 862) was designed. Diagnostic data were obtained from Clalit Health Services, the largest managed care organization in Israel. This database was established using continuous real‐time input from healthcare providers, pharmacies, medical care facilities and administrative computerized operating systems. Results After controlling for demographic and clinical variables, psoriasis was associated with anxiety (OR 1.11, 95% CI 1.01–1.23, P < 0.05), depression (OR 1.17, 95% CI 1.08–1.26, P < 0.001), and anxiety and depression co‐occurrence (OR 1.32, 95% CI 1.21–1.45, P < 0.001) among patients with low SES, yet was associated only with anxiety (OR 1.15 95% CI 1.04–1.27, P < 0.001) but not depression or comorbid anxiety–depression among patients with high SES. Survival analyses indicated that between the ages of 40 and 60, the cumulative probability of psoriasis patients with low SES to suffer from anxiety, depression and their co‐occurrence inclined more sharply with age as compared to psoriasis patients with high SES. Conclusions As psoriasis patients with low SES are prone to suffer from more severe courses of anxiety and depression, the choice of treatment of psoriasis should address the SES as well as the underlying psychiatric disease.

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Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

The association between the socioeconomic status and anxiety–depression comorbidity in patients with psoriasis: a nationwide population‐based study

Bitan

Krieger

Comaneshter

et al. 2019

Acad Dermatol Venereol

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“…A 2010 longitudinal population‐based study found chronic arthritis to be associated with mood disorders (ie anxiety or depression) . The prevalence of depressive disorder in RA was 17% (95% CI 10%‐24%), and was found to be associated with poorer outcomes . Improved understanding of the prevalence and impact of mood disorders in patients with RA will lead to early diagnosis and intervention, and improved patient quality of life.…”

Section: Introductionmentioning

confidence: 99%

“…3 The prevalence of depressive disorder in RA was 17% (95% CI 10%-24%), and was found to be associated with poorer outcomes. 4,5 Improved understanding of the prevalence and impact of mood disorders in patients with RA will lead to early diagnosis and intervention, and improved patient quality of life. Accordingly, the aim of this study was to investigate the prevalence of and factors significantly associated with depression and anxiety in patients with RA.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of and factors associated with depression and anxiety in patients with rheumatoid arthritis: A multicenter prospective cross‐sectional study

et al. 2020

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Aim To investigate the prevalence of and factors associated with depression and anxiety in patients with rheumatoid arthritis (RA). Methods This prospective cross‐sectional study included patients who were consecutively enrolled in the Siriraj Rheumatoid Arthritis Registry or the Thai Army Rheumatoid Arthritis Cohort during the September 2016 to March 2018 study period. Demographic data and clinical variables, including disease activity, functional status, health‐related quality of life, and cognitive function, were collected. Depression and anxiety were assessed using the Thai version of the Hospital Anxiety and Depression Scale (Thai HADS). Results Four hundred and sixty‐four patients were included. Mean age was 59 years, median disease duration was 9.9 years, and 85% of patients were female. Based on the Thai HADS cutoff value of 8 or higher, 12.5% and 14.5% of patients had some degree of depression and anxiety, respectively. Multivariate analysis revealed global health score (risk ratio [RR]: 0.98, P = .001) to be the only factor independently negatively associated with depression. Regarding anxiety, functional disability (RR: 2.46, P = .004) and married status (RR: 2.43, P = .009) were significantly associated with increased risk, whereas disease duration of 10 years or more (RR: 0.45, P = .007) and global health score (RR: 0.97, P < .001) were significantly associated with decreased risk of developing anxiety. Conclusion Depression and anxiety are common in patients with RA. Patients' perceptions of their current health are significantly related to mood disorders. Therefore, mental health status, especially mood disturbances, should be addressed in routine practice to improve quality of life in RA.

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“…К факторам, которые ассоциирова-лись с невозможностью достижения ремиссии, относи-лись женский пол, высокий счет ЧБС, нарушение функ-циональной активности, депрессия, ожирение и артери-альная гипертензия. Данные регистра NOR-DMARD (n=1326) также свидетельствуют о том, что наличие симптомов депрессии и тревоги достоверно снижает шансы на достижение ремиссии [31]. Интересно, что в другом исследовании, выполненном этой группой ав-торов, была отмечена дискордантность между PGA и объективными признаками активности воспаления (ЧБС/ЧПС), что существенно влияло на частоту дости-жения ремиссии [32].…”

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Rheumatoid Arthritis: The Problems of Remission and Therapy Resistance

Nasonov¹,

Олюнин²,

Лила³

2018

rsp

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Ревматоидный артрит (РА) -иммуновоспалительное (аутоиммунное) ревматическое заболевание неизвест-ной этиологии, характеризующееся хроническим эрозивным артритом и системным поражением внутрен-них органов, приводящее к ранней инвалидности и сокращению продолжительности жизни пациентов. Не-смотря на достигнутые успехи в лечении РА, связанные с разработкой новых лекарственных препаратов и совершенствованием стратегии лечения, позволяющие добиться ремиссии у многих пациентов, остается много теоретических и клинических проблем, касающихся как определения понятия «ремиссия», ее харак-теристики и типов, так и подходов к оптимальной тактике «симптоматической» и «патогенетической» лекар-ственной терапии на разных стадиях болезни, применение которой позволит быстро индуцировать состоя-ние ремиссии и поддерживать ее в долгосрочной перспективе. Необходимы дальнейшие исследования, на-правленные на изучение природы гетерогенности патогенетических механизмов РА и подходов к ранней ди-агностике, совершенствование методов мониторинга активности заболевания, биомаркеров эффективности и резистентности к терапии и, наконец, разработку дифференцированной терапии, в том числе связанной с поиском новых «терапевтических» мишеней. Rheumatoid arthritis (RA) is an immunoinflammatory (autoimmune) rheumatic disease of unknown etiology, which is characterized by chronic erosive arthritis and systemic visceral organ damage that results in early disability and shorter patient survival. Despite RA treatment advances associated with the design of novel drugs and the improvement of treatment strategies to achieve remission in many patients, there are still many theoretical and clinical problems concerning both the definition of the concept of remission, its characteristics and types and approaches to the optimum policy of symptomatic and pathogenetic drug therapy at different stages of the disease, the use of which will be able to rapidly induce and maintain remission in the long-term. Further investigations are needed to study the nature of heterogeneity of pathogenetic mechanisms of RA and approaches to early diagnosis, to improve methods for monitoring disease activity and biomarkers for the efficiency of and resistance to therapy and, finally, to develop differentiation therapy, including those related to a search for new therapeutic targets.

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Do depression and anxiety reduce the likelihood of remission in rheumatoid arthritis and psoriatic arthritis? Data from the prospective multicentre NOR-DMARD study

Abstract: Depression and anxiety may reduce likelihood of joint remission based on composite scores in RA and PsA and should be taken into account in individual patients when making a shared decision on a treatment target.

Cited by 184 publications

References 21 publications

The association between the socioeconomic status and anxiety–depression comorbidity in patients with psoriasis: a nationwide population‐based study

The association between the socioeconomic status and anxiety–depression comorbidity in patients with psoriasis: a nationwide population‐based study

Prevalence of and factors associated with depression and anxiety in patients with rheumatoid arthritis: A multicenter prospective cross‐sectional study

Rheumatoid Arthritis: The Problems of Remission and Therapy Resistance

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