Thu0684 how Many of Your Patients Have Depressive Symptoms? How to Assess During Routine Clinical Practice?

Abstract

BackgroundPatients with rheumatic diseases have a high prevalence of depressive symptoms that affect the patients’ self-assessment, adherence to medication [1], and mortality [2].ObjectivesTo evaluate patients with rheumatic diseases regarding depressive symptoms by using the PHQ-2 (Patient Health Questionnaire with 2 items) and assess its feasibility during routine clinical practice.Methods485 consecutive patients with rheumatic diseases attending a rheumatology practice that is part of the public health care system in Erlangen, Germany underwent a routine clinical assessment by different rheumatologists. In addition to disease-specific assessments and questionnaires, every patient answered two questions regarding depressive symptoms which form the PHQ-2 (range of 0[best] to 6[worst]). All questionnaires were answered digitally by touchscreen and Software RheumaDok and RheumaDokM (Nils Körber und Joachim Elgas G.b.R). A PHQ-2 score ≥ 3 points has a sensitivity of 87% and a specificity of 78% for detecting a major depressive disorder compared to a structured clinical interview. [3] A positive screening result was either addressed during subsequent medical consultation or by notifying the patient’s general practitioner. The PHQ-2 is a short form of the PHQ-9 which previously had been validated in rheumatoid arthritis. [4].ResultsOverall, 26% of patients stated depressive symptoms (PHQ score ≥ 3). Table 1 shows the prevalence of depressive symptoms by disease entity which was not significantly different among the subgroups (χ2(5)=6, p=0.3). However, given our results indicating depressiveness to be common across subgroups, all of these patients merit further evaluation. The PHQ-2 was widely accepted by patients, and seemed very feasible due to its concise form. Age PHQ-2 PHQ-2 ≥ 3 MeanMedianNSDMeanMedianNSDN%Rheumatoid Arthritis, RF+62.161.016911.91.72.01691.43722Rheumatoid Arthritis, RF-63.164.05113.71.92.0511.71631Psoriatic Arthritis54.655.05911.41.51.0591.41119Ankylosing Spondylitis47.748.04713.01.72.0471.61328Various rheumatic diseases *60.063.08214.82.02.0821.62530Not diagnosed yet/initial assessment55.855.07717.81.92.0771.72431* Polymyalgia, Connective tissue diseases, and other.ConclusionThe PHQ-2 questionnaire is a highly feasible and well accepted tool in routine clinical practice, helping to screen for depressive symptoms as a highly prevalent condition across rheumatic diseases. Real world evidence of depressive symptoms may improve healthcare by shedding light on the patients’ mental well-being and comorbidity.References[1] Brandstetter S, Riedelbeck G, Steinmann M, Loss J, Ehrenstein B, Apfelbacher C. Depression moderates the associations between beliefs about medicines and medication adherence in patients with rheumatoid arthritis: Cross-sectional study. J Health Psychol. 2016 May 04.[2] Kleinert S, Marx A, Faller H, M F, C K, Lehmann S, et al. Prevalence and Relevance of Depressive Symptoms in Patients with Rheumatic Diseases [abstract]. Arthritis Rheumatol 2015; 67 (suppl 10). 2015.[3] Lowe B, Kro...