ACR: Anxiety, Depression May Affect Achieving Minimal Disease Activity in PsA

Recognizing anxiety and depression is important in PsA, as psychological well-being may contribute to disease activity.
Recognizing anxiety and depression is important in PsA, as psychological well-being may contribute to disease activity.

WASHINGTON, DC — Researchers found lower depression and anxiety scores in psoriatic arthritis (PsA) patients who had minimal disease activity (MDA) compared with those who did not have MDA, according to data presented at the 2016 ACR/ARHP Annual Meeting, November 11-16, 2016 in Washington, DC. This suggests that recognizing depression in PsA is important because psychological well-being may contribute to disease state in PsA.

Agnes Szentpetery, MD, from St. Vincent's University Hospital in Dublin, Ireland and colleagues recruited 100 patients (age 52±10.6 years, 55% men) who fulfilled the Classification criteria for Psoriatic Arthritis (CASPAR Criteria). Depression, anxiety, and worry were assessed with the Hospital Anxiety and Depression Scale (HADS-A and HADS-D) and Penn State Worry Questionnaire (PSWQ).

Participants also completed questionnaires about health and quality of life, and underwent joint and skin assessments.

Out of the 40 patients identified who had MDA and the 60 who did not, researchers found that:

  • Tender joint count (TJC68) and swollen joint count (SJC66) were lower in MDA compared with the non-MDA group (P <.001); however, there were no significant differences in the other 5 items of MDA, or in the number of patients on DMARDs, biological treatments, or depression and anxiety medications.

  • In the MDA group, 95% had normal HADS-D scores, 5% had borderline HADS-D scores, and 0 had abnormal HADS-D scores.

  • In the non-MDA group, 80% had normal scores, 15% had borderline scores, and 5% had abnormal scores ( P=.084). The average HADS-D score was significantly lower in the MDA group compared with the non-MDA group (2.5±2.4 vs. 4.22±3.4, P =.009)

  • The percentage of patients with normal, borderline and abnormal HADS-A scores were 92.5%, 7.5% and 0 in MDA compared with 76%, 17% and 7% in non-MDA (P=.078), respectively. Mean HADS-A score was lower in MDA compared with non-MDA. 

  • The number of patients with low, moderate, and high worry scores, as well as the mean PSWQ scores, were similar in both groups.

  • Logistic regression analyses revealed a significant relationship between lower TJC (B=0.508 (CI95% 0.37-0.7) P<.001), lower HADS-D (B=0.841 (CI95% 0.71-0.99) P=.043), and MDA state. 

“Our results suggest the importance of recognizing depression in PsA since psychological well-being may contribute to MDA state,” the authors concluded.

Reference

Szentpetery A, Ikumi N, Kirby B, FitzGerald O. The presence of depression might be an important determinant of achieving minimal disease activity state in psoriatic arthritis. Presented at: 2016 ACR/ARHP Annual Meeting. November 11-16, 2016; Washington, DC. Abstract # 1701.

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