AB0295 HIGHER PREVALENCE OF DEPRESSION WITH LINK TO CHILDHOOD TRAUMA IN AN EARLY ARTHRITIS COHORT – A SELECTIVE DATA ANALYSIS (PSYRA-STUDY)

Abstract

BackgroundIn patients with arthritis, psychological co-morbidities are very common. Previous studies have found a relatively high prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD), especially in long-term disease. Recent research has begun to study psychiatric co-morbidities not just as an outcome, but also as a probable risk factor, evaluating patients in the early disease stages. [1] Furthermore, some sources suggest that childhood adversities could impact the autoimmune process in adulthood. [2]ObjectivesTo compare the prevalence of depression, anxiety, PTSD, and childhood trauma in a prospective early arthritis cohort to a healthy age- and gender-matched control group. Moreover, to explore whether these factors may contribute to the early arthritis development.MethodsThis selective data analysis of prospective single-centre, observational study included 60 patients with an early arthritis and 60 healthy controls. The control group was defined as no inflammatory joint pain and further subdivided into 2 subgroups, differentiating 24 patients with arthralgia and 36 with no arthralgia and not from the outpatient consultation. Early arthritis was defined as the presence of at least one inflammatory joint from 4 weeks to 12 months, independent of rheumatic diagnosis. For the assessment of current and prior psychological co-morbidities, included patients underwent semi-structured interview and received the standardized questionnaires for depression/anxiety (Hospital Anxiety and Depression Scale (HADS)), childhood trauma (Childhood Trauma Questionnaire (CTQ)) and PTSD (Posttraumatic Diagnostic Scale (PDS)) respectively. Differences among the groups were analyzed with Chi Square and Mann-Whitney U tests. A backwards binominal logistic regression model in reference to the healthy patients was performed to identify the significant factors for the early arthritis group.ResultsThe mean age of the total group was 47.4 ± 16.0 (♀ 58.3%, mean symptom duration 4.5±3.3 months). Depression rate of 41.7% according to interview was significantly higher in early arthritis group compared to 16.7% in healthy patients (p=0.03). Regarding arthralgia subgroup, depression was also high with 34%. HADS-D score was also significantly higher in early arthritis (5.4±4.8) to healthy cohort (3.6±3.3) (p=0.047). Compared to 3.3% in healthy patients, PTSD rate of 13.3% was also significantly higher in the arthritis group (p=0.048). We could not detect a significant difference between these two groups using the U test while evaluating CTQ dimensions. We performed a subsequent subgroup analysis and found that childhood trauma dimensions were relevant in arthralgia group, as 25% presented with high emotional abuse score. The logistic regression model showed that emotional neglect, sexual abuses in childhood as well as HADS-D were significant covariates for early arthritis. (p=0,048 OR=1.2; p=0.040 OR=1.4, p=0.025 OR=1.2 respectively).ConclusionAs the rates of depression and PTSD, as well as HADS-D score were significantly higher in the early arthritis cohort compared to healthy individuals, our findings suggest a potential link between psychiatric outcomes and inflammation. According to our regression model certain childhood adversities and depression are significant factors for an early arthritis group. Arthralgia group had similar aberrant scores regarding childhood trauma, implying that early-life stress might be an important factor in understanding this condition.