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  1. M. Brahem1,
  2. S. Abdellatif1,
  3. H. Hachfi1,
  4. A. Ben Salem1,
  5. R. Sarraj1,
  6. R. Ben Tekaya1,
  7. Y. Mohamed1
  1. 1Taher Sfar Hospital, Rhumatology, Mahdia, Tunisia


Background: Knee osteoarthritis is considered to be one of the most common causes of functional impairment, which affects the quality of life of patients leading to severe mood disorders. Our goal is to evaluate the frequency of depression and anxiety in patients with knee osteoarthritis.

Objectives: Evaluate the frequency of depression and anxiety in patients with knee osteoarthritis.

Methods: This is a cross-sectional study over a period of 7 months from February to August 2016, including consecutively patients who consulted in the Rheumatology department at Mahdia university hospital for knee osteoarthritis. We evaluated for each patient a validated version of HAD “Hospital Anxiety and Depression scale”. This score includes 14 items each one rated from 0 to 3 and two components including depression and anxiety.

Results: We included in our study 66 patients (56 women and 10 men) with an average age of 60.3 years [40-90 years]. Knee osteoarthritis was bilateral in 56.1% of cases. The examination found limited mobility of the knee in 45.5% and flessum in 13.8% of cases. Standard radiography showed stage 1 knee osteoarthritis in 4.5%, stage 2 in 31.8%, stage 3 in 56.1% and stage 4 in 7.6% of cases. All our patients were treated with analgesics, NSAIDs in 95.5%, local corticosteroid infiltrations in 43.9% and hyaluronic acid in 7.6% of cases.The mean visual analog scale(VAS)was 5.84 ±1.7 out of 10 [2-9]. The mean overall WOMAC index was 47.15±15.6 [12-82]. The average Lequesne index was 16.8±13.1, moderate disability was found in 3% of cases, significant disability in 6.1% of cases, very significant disability in 18.2% of cases and extreme disability in 72.7% of cases. The mean depression score was 9.3±2.6 [4-16], with 24.6% of the patients had no depressive symptomatology (score ≤7), 40% had doubtful depressive symptomatology (score between 8 and 10) and 35.4% of them had certain depressive symptomatology (score ≥11).The mean anxiety score was 8.88 ± 4 [0-19], 33.3% of patients had no anxiety symptoms (score ≤ 7), 34.8% had doubtful anxiety (score between 8 and 10) and 31.8% had certain anxiety (score ≥11). The statistical study found a significant correlation between the depression score and WOMAC score, but we did not find an association with age, sex, radiological stage, mobility limitation and VAS. Regarding anxiety, there was a correlation with age, WOMAC score and female gender. On the other hand, there was no correlation with VAS, Lequesne score, radiological stage and limitation of mobility.

Conclusion: Although knee osteoarthritis appears to be a benign pathology, its impact can be severe, including depression and anxiety, which are mainly influenced by the degree of functional disability. Hence psychological care is sometimes necessary in these chronic degenerative diseases.

Disclosure of Interests: None declared

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