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Rheumatoid arthritis - comorbidity and clinical aspects
FRI0150 Depression, Inflammation and Mortality in Patients with Rheumatoid Arthritis
  1. S. Kleinert1,2,
  2. A. Marx3,
  3. H. Faller4,
  4. H.-P. Tony1,
  5. M. Feuchtenberger5,
  6. C. Kneitz6,
  7. S. Lehmann3,
  8. C. Angermann3,7,
  9. G. Ertl7,
  10. S. Störk3,7,
  11. M. Breunig3,7
  1. 1Rheumatology/Clinical Immunology, University Hospital Würzburg, Würzburg
  2. 2Rheumatology and Nephrology (Medical Practice) Erlangen, Erlangen
  3. 3Comprehensive Heart Failure Center
  4. 4Medizinische Psychologie und Psychotherapie, University of Würzburg, Würzburg
  5. 5Department of Internal Medicine 2, Hospital Burghausen, Burghausen
  6. 6Klinik für Innere Medizin II, Klinikum Südstadt Rostock, Rostock
  7. 7Department of Internal Medicine I – Cardiology, University Hospital Würzburg, Würzburg, Germany

Abstract

Background Patients with rheumatoid arthritis (RA) have a high prevalence of depressive symptoms and an increased mortality.

Objectives The current prospective follow-up study investigates prevalence of depression, its association with inflammation and mortality in RA patients.

Methods 764 consecutive patients attending the rheumatology outpatient department of the University Hospital Würzburg underwent a comprehensive cardiovascular (CV) risk assessment. Inflammation in RA patients was characterized by DAS28 and CRP. Quality of life and depressive symptoms were investigated by SF-36 and PHQ-9 (range 0–27 score points), respectively. A PHQ score ≥15 points is considered indicative for severe depressive symptoms.

Results 352 subjects suffered from rheumatoid arthritis (RA: 79.5% female, 64.9% RF positive, mean age 54.3 (SD 14.3)), Severe or moderate depressive symptoms were prevalent in 6.6%, respectively 14.4% of RA patients. DAS28, but not CRP, was significantly associated with the prevalence of depressive symptoms (r=0.26 (p<0.001), figure A, table 1).

View this table:

Patients with severe depressive symptoms (PHQ 9 ≥15) had an increased a HR of 6.42 (95% CI, 2.04 – 20.2, p=0.004) for mortality compared to patients with a PHQ ≤14 (figure B).

Figure

Conclusions DAS28 in RA patients was associated with severity of depressive symptoms. Severely depressed patients had an increased mortality.

Disclosure of Interest None declared

https://doi.org/10.1136/annrheumdis-2016-eular.2473

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