When Depression Accompanies RA

Rheumatoid arthritis patients were more likely to have depression than general population

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Coping with arthritis can be difficult, especially when patients have other conditions — such as depression — that may hinder effective treatment.

A recent review of previous studies found that depression was more common in people with rheumatoid arthritis (RA) than in those without RA.

Past research has linked depression to poorer RA outcomes.

The authors of this review suggested that knowing whether an RA patient has depression could help doctors better manage that patient's treatment.

"Talk to your rheumatologist about any other health conditions you have."

Faith Matcham, of the Department of Psychological Medicine at King's College London, led this review on rheumatoid arthritis and depression.

Rheumatoid arthritis, or RA, is a disease characterized by inflamed, tender joints and tissues. Clinical depression, according to the authors, also leads to pain, fatigue and a reduced quality of life.

The authors of the review wrote that additional interventions may be necessary for RA patients who also have depression. However, the prevalence of patients who have both RA and depression is unknown.

To see how common depression was in RA patients, the researchers looked at previous studies and trials on rheumatoid arthritis that reported the number of participants with depression.

The researchers looked at 72 papers on RA which included a total of 13,189 participants. The average participant age was 53.7 years old. Most of the participants were women.

In the 72 studies, depression was defined in 40 different ways. A total of 30 studies used the Hospital Anxiety and Depression Scale, or HADS, to determine whether participants were depressed.

Within the individual studies, the prevalence of depression among the participants ranged from 0.04 percent to 66.3 percent. Altogether, the researchers found that 16.8 percent of the RA patients had depression according to the Diagnostic and Statistical Manual of Mental Disorder's (DSM) definition of the condition.

Additionally, depression was more common in study groups with younger than average RA patients.

The researchers concluded that depression was "highly prevalent" among patients who had RA. They claimed that depression was more prevalent in people with RA than in the general population or in patients with diabetes or cancer.

The authors of this review noted that there was much diversity in the studies' definitions and measurements of depression.

They wrote that different evaluation procedures were used, and the cut-off points were sometimes not consistent between studies. The authors recommended that conventional cut-off points be used in future research.

The authors also suggested that looking for and understanding depression in RA patients could significantly improve the quality of treatment that patients receive.

"It is not surprising that research verifies depression leads to pain and fatigue, and that people suffering from arthritis are more likely to be depressed," Bradley Nelson, DC, international lecturer in bio-energetic medicine and energy psychology, told dailyRx News.

"A major cause of depression is trapped emotions, the unresolved baggage people carry from past trauma. These same emotions can contribute to joint malfunction and degeneration, and arthritis," said Dr. Nelson, who was not involved in this study.

"I have seen many cases in which pain and depression abated once patients were able to release trapped emotions. If a patient is complaining of depression combined with arthritis pain, it's time to look for the underlying emotional causes," he said.

This review was published in the December issue of Rheumatology.

The research was funded by King's Health Partners Academic Health Science Centre. The authors declared no conflicts of interest.

Review Date: 
November 18, 2013
Last Updated:
December 30, 2013