Association between Proinflammatory Cytokines and Anxiety and Depression Symptoms in Rheumatoid Arthritis Patients: A Cross-sectional Study

Clin Pract Epidemiol Ment Health. 2023 Jun 22:19:e174501792304261. doi: 10.2174/17450179-v19-e230510-2022-34. eCollection 2023.

Abstract

Background: Rheumatoid arthritis (RA) patients have a greater prevalence of anxiety and depression. Proinflammatory cytokines are elevated in RA. We aim to evaluate the association between systemic inflammation in RA and anxiety and depression.

Methods: There were 31 RA patients, 16 with active disease activity and 15 in remission state; they were assessed using the Hospital Anxiety and Depression Scale and for RA disease activity using Disease Activity Score of 28 joints (DAS28) - CRP (C-reactive protein). Serum proinflammatory cytokines were measured, including interleukin (IL)-6, IL-17, and Tumour Necrosis Factor-alpha (TNF-α).

Results: Among 31 patients, ten patients showed anxiety symptoms, 19 patients showed depression symptoms, and two displayed mixed symptoms. Serum TNF-α levels were significantly higher in active disease than in the remission group (p-value 0.006). There was no association or correlation between proinflammatory cytokines to anxiety and depression symptoms in the active disease and remission groups.

Conclusion: This suggests that other factors besides disease activity and state of systemic inflammation may cause anxiety and depression in RA patients.

Keywords: Anxiety; Arthritis rheumatoid; Depression; Inflammation; Interleukin-17; Interleukin-6; Tumor necrosis factor-alpha.