Depression Linked to Early Disease Activity in Rheumatoid Arthritis

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Persistent depression was more common in patients with high and moderate disease activity compared with low activity or remission.
Persistent depression was more common in patients with high and moderate disease activity compared with low activity or remission.

SAN DIEGO — According to the results of research presented at the 2017 ACR/ARHP Annual Meeting, held November 3-8, initial high disease activity in patients with early rheumatoid arthritis is associated with an increased risk for depression and persistent depression.

To evaluate the correlation between disease activity and depression, researchers evaluated depression and persistent depression in 469 patients with early rheumatoid arthritis (mean age, 56.8 years; 72.9% women). Depression was assessed at baseline and patients were followed for ≥2 years. Baseline disease activity was measured with the Clinical Disease Activity Index, and the association between disease activity and depression was analyzed.

Depression and persistent depression were reported in 26% and 23%, respectively, of all patients with early rheumatoid arthritis. Persistent depression was more common in patients with high and moderate disease activity compared with low activity or remission (29% vs 19% vs 16%, respectively; P =.02). After controlling for sex, rheumatoid factor status, prior use of disease-modifying antirheumatic drugs, current use of biologics, disability, and number of comorbidities, patients with higher disease activity at baseline were at increased risk for baseline depression and persistent depression (odds ratio [OR], 1.04; P =.002). During follow-up, high disease activity (OR, 1.32) and moderate disease activity (OR, 1.16; P =.006) were associated with an increased risk for depression compared with low disease activity or remission. Other factors associated with persistent depression were female gender (OR, 3.17; P =.002) and greater number of comorbidities at baseline (OR 1.68; P <.001).

In conclusion, the researchers explained that the correlation between early disease activity and depression highlighted "the importance of intervening during the 'window of opportunity' to control disease activity and the potential to mitigate adverse health outcomes, including depression."

Reference

Joshi R, Movahedi M, Kuriya B, et al. High disease activity is a predictor of depression and persistent depression in early rheumatoid arthritis: Results from a rheumatoid arthritis cohort. Presented at: 2017 ACR/ARHP Annual Meeting; November 3-8, 2017; San Diego, California. Poster 2908.

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