Anxiety and depression in rheumatoid arthritis: an epidemiologic survey and investigation of clinical correlates in Iranian population

Abstract

Psychiatric disorders occur in a considerable proportion of patients with rheumatoid arthritis (RA). This study was conducted in order to evaluate the prevalence of anxiety and depression in Iranian RA patients. In the cross sectional study, 414 RA patients were enrolled prospectively during a period of 6months from RA clinic of Rheumatology Research Center. Beck's and Cattell's inventories were applied to investigate depression and anxiety in RA patients. RA activity was measured by Disease Activity Score and patients' disability was assessed by Health Assessment Questionnaire. Levels of pain perception were stratified based on Visual Analog Scale. The prevalence of depression was 63.6% and anxiety was in 84.1% among RA patients. Mixed anxiety and depression was detected in 60.2% of the study population. Functional disability was significantly associated with severity of depressive and anxiety symptoms (p<0.001); however there was no association between disease activity and depression or anxiety (p=0.420). There was weak correlation between disease activity score and functional disability (Spearman's rho=0.33; p<0.01). Severe levels of depression and anxiety were associated with higher levels of pain perception (p<0.001). Our study stressed the impact of depressive and anxiety symptoms in functional disability and pain perception of RA patients. Our results point out the multidisciplinary management of RA.