The prevalence and correlation of depression and anxiety with disease activity in rheumatoid arthritis

Sousan Moudi; Behzad Heidari; Behnaz Yousefghahari; Reza Gholami; Hemmat Gholinia; Mansour Babaei

doi:10.5114/reum/154905

The prevalence and correlation of depression and anxiety with disease activity in rheumatoid arthritis

Reumatologia. 2023;61(2):86-91. doi: 10.5114/reum/154905. Epub 2023 Feb 1.

Authors

Sousan Moudi¹, Behzad Heidari², Behnaz Yousefghahari², Reza Gholami³, Hemmat Gholinia², Mansour Babaei⁴

Affiliations

¹ Health Research Center, Master of Biostatistics and Epidemiology, Babol University of Medical Science, Iran.
² Clinical Research Development Unit of Rouhani, Babol University of Medical Sciences, Iran.
³ Student Research Committee, Babol University of Medical Sciences, Iran.
⁴ Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Iran.

Abstract

Introduction: Depression and anxiety share similar symptoms with rheumatoid arthritis (RA) and these conditions are often not diagnosed or overlooked in RA. This study aimed to determine the prevalence of depression/anxiety in RA and their correlation with RA activity.

Material and methods: Rheumatoid arthritis patients who presented at a rheumatology clinic were selected consecutively. The diagnosis of RA was confirmed by the ACR/EULAR criteria, disease activity was assessed by Disease Activity Score based on the 28-joint count (DAS28) and patients with DAS28 > 2.6 were considered to have active RA. The diagnosis of depression and anxiety was made by the Hospital Anxiety and Depression Scale (HADS). The Pearson test was used to determine the correlation between DAS28 and HADS scores.

Results: Two-hundred patients (female, 82%) with a mean age of 53.5 ±10.1 years and mean disease duration of 6.6 ±6.8 years were studied. Depression was diagnosed in 27 (13.5%) patients and anxiety in 38 (19%) patients. The DAS28 score correlated positively with depression (r = 0.173, p = 0.014) and anxiety score (r = 0.229, p = 0.001). In multiple logistic regression analysis after adjustment for all covariates, age < 40 years and female sex were independently associated with RA activity in patients with depression, with OR = 4.21 (p = 0.002) and OR = 3.56 (p = 0.028) respectively.

Conclusions: These findings indicate that depression and anxiety are prevalent in RA and correlate positively with active disease in particular in depressive female patients aged < 40 years.

Keywords: anxiety; depression; disease activity score; rheumatoid arthritis.