Magazine article Clinical Psychiatry News

Depressed Mood, RA Disease Activity Linked

Magazine article Clinical Psychiatry News

Depressed Mood, RA Disease Activity Linked

Article excerpt

FROM ANNALS OF THE RHEUMATIC DISEASES

In patients with rheumatoid arthritis, higher disease activity scores were associated with more severe depression, both when measured at the same time and at 6 months apart, suggesting that the impact the two factors have on each other persists over time.

Similarly, depression predicted increased disease activity later.

The findings, while not necessarily causal, "support the notion that in patients with more severe depressed mood, disease activity is probably greater, not only at the same time but also several months later, and that in patients with more swollen and painful joints, psychological distress is probably greater at the same time and later on," wrote Dr. Cecile L. Overman of the department of clinical and health psychology at Utrecht University (the Netherlands), and associates (Ann. Rheum. Dis. 2011 Sept. 14 [doi: 10.1136/annrheumdis-2011-200338]).

The researchers looked at 545 patients with a recent diagnosis of rheumatoid arthritis (RA) recruited between 1990 and 2002 in the Utrecht region. The patients were enrolled in a prospective drug trial at the time.

Patients with comorbid psychiatric disorders or drug use were excluded.

Psychological distress was assessed at baseline, before randomization, and then annually for 5 years with the Impact of Rheumatic Diseases on General Health and Lifestyle (IRGL) questionnaire. The anxiety portion of IRGL consists of 10 items (scored from 10 to 40) derived from the Spielberger state-trait anxiety inventory; the depressed mood scale consists of six items (scored from 0 to 24).

Disease activity according to erythrocyte sedimentation rate (ESR) and the Thompson articular index was assessed at baseline, every 3 months for the first 2 years, and every 6 months for the next 3 years. At baseline, the authors found that 45% of patients had a depressed mood according to the IRGL scale, while 36% had anxiety. …

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