Depression, Anxiety Reduce Likelihood of Achieving Minimal Disease Activity in Psoriatic Arthritis

Symptoms of anxiety and depression were found to reduce the probability of sustained minimal disease activity in PsA.

Anxiety and depression are associated with a lower probability of achieving sustained minimal disease activity (MDA) in psoriatic arthritis (PsA), according to study results published in Arthritis Care & Research (Hoboken).

Patients with PsA were assessed every 6 to 12 months between 2008 and 2017. Researchers defined MDA as having met criteria for at least 2 consecutive visits and was determined using both participant-reported outcomes and physician assessment. The 3 definitions of depression/anxiety used for identification purposes included Medical Outcomes Study Short Form 36 (SF-36) mental component summary score of 38 or lower; SF-36 mental health domain score of 56 or lower; and a report by a rheumatologist of treatment for or diagnosis of depression/anxiety. To identify factors related to the achievement of sustained MDA, the researchers used a discrete time-to-event analysis.

A total of 743 adults with PsA (56% men; mean age at baseline visit, 50.2±13.2 years; mean age at PsA diagnosis, 38.3±13.8 years) were included in the study. Among the study participants, 45.36% did not achieve sustained MDA. Furthermore, 31% met the criteria for all 3 definitions of depression/anxiety (definition 1, 44.54%; definition 2, 48.99%; definition 3, 28.4%). Overall, depression/anxiety was associated with an approximately 60% to 75% lower likelihood of achieving MDA (definition 1, odds ratio [OR], 0.30 [0.22-0.39]; definition 2, OR, 0.34 [0.26-0.45]; definition 3, OR, 0.47 [0.35-0.65]; P <.0001 for all). Fibromyalgia and the Charlson comorbidity index were also associated with a lower likelihood of sustained MDA.

Limitations to the study included a lack of formal psychiatric assessment or specific anxiety/depression questionnaire, as well as an inability to include all individuals in the database due to incompatibility with inclusion criteria.

Study authors concluded that “the presence of depression/anxiety, regardless of the method used to define it, is associated with a lower probability of achieving sustained MDA in patients [with PsA].” They added, “Comprehensive management of PsA should therefore include measures for addressing anxiety and depression so that more patients achieve a state of MDA.”

This article originally appeared on Rheumatology Advisor


Wong A, Ye JY, Cook RJ, Gladman DD, Chandran V. Depression and anxiety reduce the probability of achieving a state of sustained minimal disease activity in patients with psoriatic arthritis. Arthritis Care Res (Hoboken). Published online June 8, 2022. doi: 10.1002/acr.24593