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

Katchamart, Wanruchada; Narongroeknawin, Pongthorn; Chanapai, Wanwisa; Thaweeratthakul, Phakhamon; Srisomnuek, Ananya

doi:10.1111/1756-185x.13781

Cited by 31 publications

(36 citation statements)

References 22 publications

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“…Therefore, after adjustment, the effects of other factors associated with anxiety and depression symptoms may be more robust than disease activity. We also found that PtGA (a component of the DAS28-CRP composite measure) was notably associated with anxiety and depression symptom, which is similar to findings from a previous study [37]. Moreover, the multivariable analysis results suggested that inflammation (CRP, TJC, and SJC) was not associated with anxiety and depression.…”

Section: Discussionsupporting

confidence: 89%

Factors associated with anxiety and depression in rheumatoid arthritis patients: a cross-sectional study

et al. 2021

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Background The management of anxiety and depression symptoms in rheumatoid arthritis (RA) patients is vital. Previous study findings on this topic are conflicting, and the topic remains to be thoroughly investigated. This study aimed to clarify the association of RA disease activity with anxiety and depression symptoms after controlling for physical disability, pain, and medication. Methods We conducted a cross-sectional study of RA patients from the Kyoto University Rheumatoid Arthritis Management Alliance cohort. We assessed patients using the Disease Activity Score (DAS28), Health Assessment Questionnaire Disability Index (HAQ-DI), and Hospital Anxiety and Depression Scale (HADS). Anxiety and depression symptoms were defined by a HADS score ≥ 8. We analyzed the data using multivariable logistic regression analyses. Results Of 517 participants, 17.6% had anxiety symptoms and 27.7% had depression symptoms. The multivariable logistic regression analysis demonstrated that DAS28 was not independently associated with anxiety symptoms (odds ratio [OR] [95% confidence interval; CI] 0.93 [0.48–1.78]; p = 0.82) and depression symptoms (OR [95% CI] 1.45 [0.81–2.61]; p = 0.22). However, DAS28 patient global assessment (PtGA) severity was associated with anxiety symptoms (OR [95% CI] 1.15 [1.02–1.29]; p = 0.03) and depression symptoms (OR [95% CI] 1.21 [1.09–1.35]; p < 0.01). Additionally, HAQ-DI scores ≤ 0.5 were associated with anxiety symptoms (OR [95% CI] 3.51 [1.85–6.64]; p < 0.01) and depression symptoms (OR [95% CI] 2.65 [1.56–4.50]; p < 0.01). Patients using steroids were more likely to have depression than those not using steroids (OR [95% CI] 1.66 [1.03–2.67]; p = 0.04). Conclusions No association was found between RA disease activity and anxiety and depression symptoms in the multivariable logistic regression analysis. Patients with high PtGA scores or HAQ-DI scores ≤ 0.5 were more likely to experience anxiety and depression symptoms, irrespective of disease activity remission status. Rather than focusing solely on controlling disease activity, treatment should focus on improving or preserving physical function and the patient’s overall sense of well-being.

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Section: Discussionsupporting

confidence: 89%

Factors associated with anxiety and depression in rheumatoid arthritis patients: a cross-sectional study

et al. 2021

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“…2 Despite effective symptom-specific treatments for both seasonal allergic rhinoconjunctivitis and rheumatoid arthritis (RA), levels of non-specific sickness symptoms, including depressed mood, anxiety and fatigue, are high. [3][4][5][6][7][8] Poor subjective sleep is commonly also reported in both conditions. 5,[9][10][11][12][13] The pathophysiology of both allergy and RA involves systemic inflammation, and inflammatory cytokines can be related to sleep disturbances and fatigue and are involved in regulation of sleep.…”

Section: Introductionmentioning

confidence: 98%

Objective and Subjective Sleep in Rheumatoid Arthritis and Severe Seasonal Allergy: Preliminary Assessments of the Role of Sickness, Central and Peripheral Inflammation

Tamm¹,

Lensmar²,

Andréasson³

et al. 2021

NSS

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Introduction Disturbed sleep in inflammatory disorders such as allergy and rheumatoid arthritis (RA) is common and may be directly or indirectly related to disease processes, but has not been well characterized in these patient groups, especially not with objective methods. Aim The present study aimed to characterize objective and subjective sleep in patients with allergy or RA using sleep diaries, one-channel EEG and actigraphy. It also aimed to investigate if sleep measures were associated with central immune activation, assessed using translocator protein (TSPO) positron emission tomography, as well as cytokine markers of peripheral inflammation and disease-specific symptoms or general symptoms of sickness. Methods In total, 18 patients with seasonal pollen allergy, 18 patients with RA and 26 healthy controls were included in the study. Allergy patients and matched controls were assessed twice, in and out of pollen season, and RA patients and controls were assessed once. Sleep was recorded for approximately 1 week at each occasion. Results Patients with allergy had increased levels of slow-wave sleep during pollen season. In contrast, patients with RA had less SWS compared to healthy controls, while no differences were observed in sleep duration or subjective sleep quality. Across groups, neither proinflammatory cytokines, grey matter TSPO levels nor general sickness symptoms were associated with objective or subjective measures of sleep. Rhinitis, but not conjunctivitis, was correlated to worse subjective sleep and more slow wave sleep in allergy. Functional status, but not disease activity, predicted lower subjective sleep in RA. Conclusion This study tentatively indicates that both patients with allergy and RA display sleep alterations but does not support inflammation as an independent predictor of the sleep disturbance across these patient groups.

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“…The psychological effects of RA can be seen in many areas of life such as family life and social relationships, therefore, it can lead to mood disorders (5). These mood disorders can cause pain, increased disease activity, cytokine release, immune-modulatory responses, and sleep disorders in patients.…”

Section: Introductionmentioning

confidence: 99%

Restless Leg Syndrome and Sleep Disorders in Patients with Rheumatoid Arthritis and Its Relation with Anemia Parameters

Demir

Küçük

Altaş

et al. 2021

Acta Med. (Hradec Kralove, Czech Repub.)

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Objectives: We aimed to investigate the prevalence of restless legs syndrome (RLS) and sleep disorders in patients with rheumatoid arthritis (RA), and the association of iron deficiency with them. Materials and methods: The study included 72 patients with RA (59 females, 13 males), and 50 healthy control subjects (57 females, 15 males). Assessments were made using the International RLS Rating Scale, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, Fatigue Severity Scale (FSS), Beck anxiety and depression index and the SF-36 quality of life scores. Results: We found that the frequency of RLS in RA patients was 29.1% and 13.8% in healthy control (p = 0.021). RA patients had 44.4% iron deficiency and 5.5% anemia of chronic disease. We found that 52.3% of patients with iron deficiency had RLS. There was an independent relationship between present of RLS and FSS (Beta [β] = 0.317, p = 0.005) and total iron binding capacity (TIBC) (β = 0.244, p = 0.031). There was an independent relationship between RLS severity score and PSQI (β = 0.264, p = 0.025) and social functionality (β = 0.302, p = 0.009). Conclusion: The prevalence of iron deficiency is high in RA in the developing countries. Analysis obtained in patients with RA is suggestive of an association between iron deficiency and increased frequency of RLS. The presence of RLS in patients with RA negatively affects sleep quality, psychiatric status, and quality of life of patients with RA. TIBC value may be a predictive marker for early detection of RLS in patients with RA.

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

Cited by 31 publications

References 22 publications

Factors associated with anxiety and depression in rheumatoid arthritis patients: a cross-sectional study

Factors associated with anxiety and depression in rheumatoid arthritis patients: a cross-sectional study

Objective and Subjective Sleep in Rheumatoid Arthritis and Severe Seasonal Allergy: Preliminary Assessments of the Role of Sickness, Central and Peripheral Inflammation

Restless Leg Syndrome and Sleep Disorders in Patients with Rheumatoid Arthritis and Its Relation with Anemia Parameters

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