Does Having Rheumatoid Arthritis Increase the Dose of Depression Medications? A Mendelian Randomization Study

Wan, Xianjie; Xie, Jiale; Yang, Mingyi; Yu, Hui; Hou, Weikun; Xu, Ke; Wang, Jiachen; Xu, Peng

doi:10.3390/jcm12041405

Cited by 3 publications

(1 citation statement)

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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%

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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Section: Discussionmentioning

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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Unveiling the skin microbial guardians and assailants in psoriasis subtypes: a Mendelian randomization study

Zhang,

Jiang,

Zhang

et al. 2024

Arch Dermatol Res

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Investigating the Causal Relationship Between Sleep-Related Traits and Self-Reported Diabetes: A Mendelian Randomization Study

Nisamudheen,

Velayutham,

Jithesh

2024

Preprint

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ObjectiveSelf-reported data can be a valuable resource for understanding health outcomes, behaviors, disease prevalence, and risk factors, yet underutilized in epidemiological research. While observational studies have linked sleep traits with diabetes, evidence using self-reported diabetes data for causal connection is lacking.MethodsWe performed a two-sample Mendelian randomization (MR) analysis using Inverse Variance Weighting (IVW), IVW with multiplicative random effects (IVW-MRE), Maximum Likelihood (ML), MR-Egger regression, and Weighted Median models, with genetic variants linked to five sleep traits (sleep duration, insomnia, snoring, daytime dozing, and chronotype) and self-reported diabetes from the UK Biobank dataset. The study utilized MR-Egger and MR-PRESSO regression to evaluate pleiotropy and outliers, IVW Q statistics to detect heterogeneity, the MR-Steiger test to assess directionality, and leave-one-out sensitivity analysis to ensure the reliability.ResultsML provided positive causal associations between genetically predicted insomnia (p = 0.002, OR = 1.021, 95% CI: 1.008–1.035) and daytime dozing (p = 0.014, OR = 1.029, 95% CI: 1.006–1.052) with diabetes, while IVW and IVW-MRE analysis showed a trend towards significance. Snoring showed mixed evidence, while genetically predicted sleep duration was marginally associated with diabetes (p = 0.053, OR = 0.992, 95% CI: 0.984–1.000) with the weighted median method, indicating a potential small protective effect. No causal association was found between chronotype and diabetes.ConclusionThis exploratory MR study provides evidence for the effect of insomnia, daytime dozing, sleep duration and snoring on diabetes risk. These findings underscore the importance of considering self-reported health outcomes in epidemiological research.Article HighlightsWhy did we undertake this study?We undertook this study to explore the causal relationships between sleep-related traits and diabetes using self-reported data, as previous prospective, retrospective or other observational studies have shown associations but lacked causal evidence using self-reported data.What is the specific question(s) we wanted to answer?We aimed to answer whether sleep-related traits, such as sleep duration, insomnia, snoring, daytime dozing, and chronotype, have a causal impact on diabetes which is self-reported.What did we find?Our two-sample Mendelian Randomization (MR) analysis found that genetically predicted insomnia and daytime dozing have a positive causal association and sleep duration was marginally associated with diabetes.What are the implications of our findings?These findings suggest that certain sleep traits may contribute to diabetes risk, highlighting the importance of considering sleep in diabetes prevention and treatment strategies. The results also emphasize the value of using self-reported health outcomes in epidemiological research and clinical interventions.

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Does Having Rheumatoid Arthritis Increase the Dose of Depression Medications? A Mendelian Randomization Study

Cited by 3 publications

References 61 publications

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

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

Unveiling the skin microbial guardians and assailants in psoriasis subtypes: a Mendelian randomization study

Investigating the Causal Relationship Between Sleep-Related Traits and Self-Reported Diabetes: A Mendelian Randomization Study

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