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Depression and anxiety associate with less remission after 1 year in rheumatoid arthritis
  1. Aleid C Boer1,
  2. Tom W J Huizinga1,
  3. Annette H M van der Helm-van Mil1,2
  1. 1 Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  2. 2 Department of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands
  1. Correspondence to Aleid C Boer, Department of Rheumatology, Leiden University Medical Center, Leiden 2300 RC, The Netherlands; a.c.boer{at}

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Depression and anxiety have been considered to influence disease activity, and with great interest we read the recently published report by Michelsen et al.1 In this large, prospective, multicentre observational study, depression and anxiety reduced the likelihood of joint remission based on composite scores, in rheumatoid arthritis (RA) after 3 and 6 months. Differences were predominantly caused by subjective markers of disease activity rather than by C reactive protein or erythrocyte sedimentation rate. The study cannot prove causality; however, their findings imply that baseline depression/anxiety can impair the fulfilment of remission criteria during follow-up, influencing important treatment decisions.

As replication is a keystone in research, we aimed to validate their findings in an independent cohort, the Leiden Early Arthritis Clinic (EAC), to assess generalisability of the results. The EAC is a population-based inception cohort of patients with newly diagnosed arthritis that started in 1993; from 2010 onwards patients completed the Short Form-36 (SF-36) at …

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