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

Abstract

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.

Comorbidities and extra-articular manifestations of Rheumatoid arthritis in sub-Saharian Africa

“…Several situations promote the occurrence or aggravation of these extra-articular manifestations, including the environment, age, male sex, but also certain modifiable factors such as smoking, diet, obesity, dyslipidemia, high blood pressure or diabetes [8,9]. To these, we also (add) cite depression favored by the pain felt by the patient, impaired quality of life, extra-articular manifestations and comorbidities [10,11]. The latter are already present in a third of patients screened for polyarthritis and can reach 80% in the long term in developed countries and a higher prevalence in developing countries [12].…”