Background An ever increasing body of research confirm that rheumatoid arthritis is associated wuth depression.
Assessment of presence and severity of depression in patients suffering from RA.
Determination of the connection between depression with the activity of the disease, functional status, and radiological stage of the disease.
To examine the effect of therapy on the severity of depression.
Methods The examination was conducted with 276 patients with RA (82.24% women and 17.76% men), with the average age of 5563±14.46 years. The average duration of the disease was 48.4±20.3 months. The control group comprised 145 healthy examinees homogenous with the examined group in age and sex distribution. The activity of the disease was determined using the DAS 28 SE index, the functional status was determined on the basis of an HAQ questionnaire, while the degree of radiological damage was determined using the Larsen score (0–200).
The intensity of pain was determined by the examinees themselves on the visual-analog pain scale VAS (0–100mm). The degree of depressivity was determined through application of the Beck scale for depression.
The statistical data processing was performed in the SPSS package, version 15.0.
Results The symptoms of depression were registered in 73.19% of patients, significantly more than in CG (21.34%), p<0.01. Mild depressivity was registered in 37.62% of patients, moderate in 28.71%, pronounced in 14.76%, and major depression in 8.91% of patients.
Out of the total number of examinees, 34.78% received combined therapy (MTX + biological therapy). 65.22% of patients were treated using monotherapy (MTX). The mean value of the Beck index of the patients receiving biological therapy was significantly lower than the value of the Beck index of the patients receiving monotherapy MTX (11.8±7.16 vs.16.86±8.09).
The connection between the ages of patients, the duration of the disease, DAS 28 SE, VAS of pain, Larsen score and HAQ index with the Beck index of depressivity was studied. The results of the univariant logistic regression show that the degree of depression is separately affected by the duration of the disease and the functional status of the patient. The multivariant model of logistic regression emphasizes the functional status as the most dominant predictor of depressivity (coef. Beta 0.764), p<0.001.
Conclusions Depression is a frequently present manifestation of RA which is most prominently influenced by the degree of functional disability of RA patients. Apart from the medication therapy, the treatment of RA requires an individual psychosocial approach and wider social support.
Margaretten M, Yelin E, Imboden J, et al. Predictors of depression in a multiethnic cohort of patients with rheumatoid arthritis. Arthritis Rheum. 2009;61(11):1586–1591
McNamara D. Depression interferes with anti-TNF therapy. Rheumatology News. 2007;6(6)
Disclosure of Interest None declared