Abstract
This longitudinal analysis compares the prevalence of depressive symptoms in patients with psoriatic arthritis in the context of the COVID-19 pandemic. Data from a national patient register in Germany were analyzed regarding the Patient Health Questionnaire 2 (PHQ-2) to identify cases suspicious for depression at two time points, i.e., before and during the COVID-19 pandemic. Only patients with complete concurrent information on the Disease Activity in Psoriatic Arthritis Score (DAPSA) were included in the analysis. The frequency of depressive symptoms in psoriatic arthritis patients during the COVID-19 pandemic did not differ from the prevalence rates measured before. In addition, prevalence rates for depressive symptoms did not differ when stratifying the patient sample for DAPSA levels of disease activity measured before the pandemic. These results were confirmed further in a sensitivity analysis, limiting the second PHQ-2 assessment to lockdown periods only. However, longitudinal data on the prevalence of depressive symptoms in patients with rheumatic diseases, in general, and psoriatic arthritis, in particular, are scarce in the context of the COVID-19 pandemic. For a sensible comparison of prevalence rates for depressive symptoms in the future, underlying SARS-CoV-2 infection rates and resulting local healthcare disruptions need to be taken into account, besides the potential use of different depression screening tools to evaluate resulting numbers sensibly and draw corresponding conclusions for patient care.
Highlights
Depression is acknowledged as frequent comorbidity in inflammatory arthritis [1,2,3,4]
Regarding the prevalence of depressive symptoms identified by the Patient Health Questionnaire 2 (PHQ-2), our results align with the numbers given by recent systematic reviews in Psoriatic arthritis (PsA) [1, 2]
The results of our data analysis suggest depressive symptoms not to occur more often during the SARS-CoV-2 pandemic compared to the 2019 data for patients having completed a depression screening at both time points
Summary
Depression is acknowledged as frequent comorbidity in inflammatory arthritis [1,2,3,4]. Regular depression screening has not been implemented into routine rheumatology care yet to help identify patients needing professional mental healthcare support. In a corresponding qualitative analysis of reported perceptions given by patients referring to the pandemic, the following key themes were identified: emotions in response to the pandemic, perceptions of risks from immunosuppressive medications, protective measures to reduce risk of SARS-CoV-2 infection, and disruptions in accessing rheumatic disease medications [7]. Systematic reviews and meta-analyses have reported a high prevalence of depression in the general population, in (front-line) healthcare professionals, and patients diagnosed with SARSCoV-2 during the pandemic [10,11,12,13,14]. Longitudinal data on this topic are scarce and, little is known about whether the prevalence of depressive symptoms in PsA patients has increased during the COVID-19 pandemic. This retrospective analysis of PsA patient data aims to add some information to this gap and addresses whether depressive symptoms were more frequent during the COVID-19 pandemic than they were before
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