Depression Lowers Clinical Response to Arthritis Therapy
McNamara, Damian, Clinical Psychiatry News
BIRMINGHAM, ENGLAND -- Rheumatologists should screen or refer patients for depression assessment before prescribing anti-tumor necrosis factor-[alpha] therapy, according to a study presented at the annual meeting of the British Society for Rheumatology.
Researchers found that depressed patients are significantly more likely to experience side effects and discontinue therapy than their nondepressed counterparts. This finding takes on particular importance since patients with depression tend to be those with the most severe rheumatoid arthritis, Dr. John C. Packham said in an interview during a poster session.
"If you look at [rheumatology] registries, there are no psychological data collected. Some studies use an SF-36, but there [are] no mood or anxiety data," said Dr. Packham, who is a rheumatologist at Staffordshire Rheumatology Centre, Haywood Hospital, Stoke on Trent, England.
The investigators assessed depression among all rheumatoid arthritis patients starting anti-tumor necrosis factor (TNF)-[alpha] therapy at the Centre since 2002. The researchers used the Beck Depression Inventory II and measured disease activity scores at study entry.
A total of 114 patients started a new anti-TNF-[alpha] agent on 136 occasions during the study. There were 65 prescriptions for infliximab, 51 for etanercept, and 20 for adalumimab. A total of 55 prescriptions were written while patients were moderately to severely depressed, defined as a Beck Depression score of greater than 20. …