63 percent of RA patients suffer psychiatric disorders, with depressive spectrum conditions most likely
Copenhagen, Denmark, Friday 12 June 2009: Over half (63%) of patients with rheumatoid arthritis (RA) also suffer from psychiatric disorders, with the majority of these (87%) occurring in the depressive spectrum, according to the results of a new study presented today at EULAR 2009, the Annual Congress of the European League Against Rheumatism in Copenhagen, Denmark. Interestingly, over half (52%) of the patients studied indicated that they had experienced stress events before the onset of their RA. The study also revealed a number of other interesting findings about the emotional burden of RA:
- Cognitive dysfunction was diagnosed in 23% of patients, with 16% of this attributed to depression
- A third (33%) suffered from sleep disorders
- Those with depression also exhibited more severe RA (measured by X-ray), greater functional insufficiency and pain, as well as having received less aggressive treatment than patients without depression. (No significant differences in age, duration of illness, gender or DAS28* scores were noted between the two groups)
- Significantly, cognitive impairments were found more often (p=0.02) in patients older than 50 years (39% vs. 9%)
- The age of the first prednisone intake was significantly higher (p<0.05) in patients with depression compared to those without (48 vs. 30 years)
Dr Tatiana Lisitsyna from the State Institute of Rheumatology RAMS, Russian Federation, who conducted the study, said: "Psychiatric disorders are a very common comorbidity for people with RA, and they tend to be stress-related and associated with disease activity and chronic pain. Evaluating and addressing the mental health of those with RA should be a regular feature of rheumatology practice to improve quality of life and reduce the potentially distressing psychological burden of RA."
In the study, the disease activity of 75 patients with American College of Rheumatology (ACR) defined RA (96% female, median age 52 years (46-55), median disease duration 12 years (4-22) was assessed using DAS28* with a median score of 4.98 (3.71 - 6.4). Median prednisone intake duration was 34 months (3-72) and 80% of patients were taking DMARDs (49% methotrexate; 23% leflunomide). Using the Brief Pain Inventory (BPI) scale to assess pain, 74% were considered to have either severe (7-10 points) or moderate (5-6 points) pain.
Psychiatric disorders were diagnosed in accordance with the ICD-10 (International Classification of Disease) scale, and other psychiatric and psychological scales used included: the Hospital Anxiety and Depression Scale for screening, the Hamilton Anxiety Rating Scale and the Montgomery-Asberg Depression Rating Scale. Projective psychological methods were employed for evaluation of cognitive function.
* DAS28 (Disease Activity Score) is an index used by physicians to measure how active an individual's RA is. It assesses number of tender and swollen joints (out of a total of 28), the erythrocyte sedimentation rate (ESR, a blood marker of inflammation), and the patient's 'global assessment of global health'. A higher score indicates more active disease.
Source: European League Against Rheumatism
Articles on the same topic
- Canakinumab shows promising efficacy and tolerability in children with systemic JIAMon, 15 Jun 2009, 13:37:34 UTC
- Increased levels of certain cytokines and chemokines predict onset of rheumatoid arthritisMon, 15 Jun 2009, 13:37:33 UTC
- Tracking levels of key biomarkers reflects disease activity and progression of rheumatoid arthritisMon, 15 Jun 2009, 13:37:32 UTC
- RA individuals from lower GDP countries keep working despite worse symptoms than richer countriesFri, 12 Jun 2009, 19:39:40 UTC
- Over half of people with rheumatoid arthritis have periodontitisFri, 12 Jun 2009, 19:39:36 UTC
- Better access to info and dialogue with HCPs on sexual issues for rheumatology patientsFri, 12 Jun 2009, 14:08:58 UTC
- Diagnosis of arthritis 5 years earlier in childless women compared to those with childrenFri, 12 Jun 2009, 14:08:52 UTC
- 1/4 of patients on highest investigational doses of CP-690,550 achieve ACR70 at week 12Fri, 12 Jun 2009, 14:08:47 UTC
- New treatment strategy offers hope to RA patients who failed all other therapiesFri, 12 Jun 2009, 14:08:42 UTC
- Exercise improves functional and psycological ability and reduces steroid need in rheumatoid arthritisFri, 12 Jun 2009, 14:08:37 UTC
- Anxiety and depression lower quality of life in majority of systemic lupus erythematosus patientsFri, 12 Jun 2009, 13:44:14 UTC
- Novel DNA vaccine leads to kidney damage prevention in systemic lupus erythematosus modelsThu, 11 Jun 2009, 14:58:51 UTC
Other sources
- Tracking levels of key biomarkers reflects disease activity and progression of rheumatoid arthritisfrom PhysorgMon, 15 Jun 2009, 15:14:53 UTC
- Canakinumab shows promising efficacy and tolerability in children with systemic JIAfrom Science BlogMon, 15 Jun 2009, 13:35:30 UTC
- Increased levels of certain cytokines and chemokines predict onset of rheumatoid arthritisfrom Science BlogMon, 15 Jun 2009, 13:35:30 UTC
- Tracking levels of key biomarkers reflects disease activity and progression of rheumatoid arthritisfrom Science BlogMon, 15 Jun 2009, 13:35:28 UTC
- RA individuals from lower GDP countries keep working despite worse symptoms than richer countriesfrom PhysorgFri, 12 Jun 2009, 21:28:52 UTC
- Over Half Of People With Rheumatoid Arthritis Have Periodontitisfrom Science DailyFri, 12 Jun 2009, 19:35:57 UTC
- New Approach To Prevent Antibody-mediated Damage In Kidney Transplantsfrom Science DailyTue, 9 Jun 2009, 2:21:35 UTC