Predictors of depression in a sample of 1,021 primary care patients with osteoarthritis

Abstract

Objective. Although there is a strong relationship between depression, chronic pain, and physical activity, there are few findings regarding the prevalence and predictors of depression in patients with osteoarthritis (OA). The goal of the present study was to assess the prevalence and severity of depression in a large sample of patients with OA and to reveal predictors of depression. Methods. Patients were approached consecutively in 75 general practices. Of 1,250 distributed questionnaires, 1,021 were returned and analyzed. Besides sociodemographic data, medication and comorbidities, depression, and arthritis were assessed using the Patient Health Questionnaire (PHQ-9) and the Arthritis Impact Measurement Scale. A stepwise multiple linear regression analysis with the PHQ-9 score as the dependent variable was performed. Results. On the PHQ-9, 19.76% of men and 19.16% of women achieved a score of >15, indicating at least a moderately severe depression. Significant sex differences could not be revealed. The strongest predictor for depression severity was perceived pain (␤ ‫؍‬ 0.243, P < 0.001) and few social contacts (␤ ‫؍‬ 0.218, P < 0.001). Further predictors were physical limitation of the lower body (␤ ‫؍‬ 0.157, P < 0.001) and upper body (␤ ‫؍‬ 0.163, P < 0.001), age (␤ ‫؍‬ ؊0.168, P < 0.001), and body mass index (␤ ‫؍‬ 0.080, P ‫؍‬ 0.020). Conclusion. These findings suggest an increased prevalence of depression among patients with OA and emphasize the need for recognition and appropriate treatment. Most of the revealed predictors are influenceable and should be potential targets in a comprehensive treatment of OA to interrupt the vicious circle of pain, physical limitation, and depression.

Targeting Care

“…Compared with their peers, people with OA report increased prevalence of depression and depressed mood (29). The intensity of perceived OA pain has been demonstrated to be predictive of depression severity in this cohort (29).…”

“…Compared with their peers, people with OA report increased prevalence of depression and depressed mood (29). The intensity of perceived OA pain has been demonstrated to be predictive of depression severity in this cohort (29). Poor mental health has been associated with worse overall hip and knee OA pain and deterioration in mental health has been found to precede short term exacerbations of OA pain (30).…”

Osteoarthritis: etiology, epidemiology, impact on the individual and society and the main principles of management

“…OA also has been implicated as a major cause of admission to nursing homes (43). An increased prevalence of at least a moderately severe depression related to perceived pain, few social contacts, physical limitation of upper and lower body, age, and body mass index is observed among patients with OA (44). The data of the Johnston County Osteoarthritis Project (n=2682) indicate that symptomatic hip and knee OA were signifi cantly associated with sleep problems, independent of other factors related to sleep diffi culties, including self-rated health and depression; therefore, it is recommended to screen patients with OA regularly for sleep disturbances as a part of routine care (45).…”

Healthcare Expenditures Associated with Depression Among Individuals with Osteoarthritis: Post-Regression Linear Decomposition Approach

“…With increasing obesity, physical inactivity and an aging population, the prevalence of osteoarthritis and its consequent economic burden is likely to increase in the US. 5 Depression and depressive symptoms are common among individuals with osteoarthritis, [6][7][8] as osteoarthritis causes chronic pain and disability, which are both underlying factors for depression. 7 The prevalence of depression among individuals with arthritis can be very high, ranging from 17 to 27 %, depending on the type of arthritis and definition of depression.…”

“…5 Depression and depressive symptoms are common among individuals with osteoarthritis, [6][7][8] as osteoarthritis causes chronic pain and disability, which are both underlying factors for depression. 7 The prevalence of depression among individuals with arthritis can be very high, ranging from 17 to 27 %, depending on the type of arthritis and definition of depression. [9][10][11][12] It has been estimated that among adults in the age group of 54-65 years, 18.1 % of major depression is attributable to arthritis.…”