Abstract
Background & AimsTo evaluate the risk of depressive disorders among rheumatoid arthritis (RA) by using the Taiwan National Health Insurance Research Database (NHIRD).MethodsWe conducted a retrospective study of a matched cohort of 18 285 participants (3 657 RA patients and 14 628 control patients) who were selected from the NHIRD. Patients were observed for a maximum of 10 years to determine the rates of newly diagnosed depressive disorders, and Cox regression was used to identify the risk factors associated with depressive disorders in RA patients.ResultsDuring the 10-year follow-up period, 205 (11.2 per 1000 person-years) RA patients and 384 (5.1 per 1000 person-years) control patients were diagnosed with depressive disorders. In RA patients, most depressive disorders (n = 163, 80%) developed with five years of being diagnosed with RA. The incidence risk ratio of depressive disorders between RA patients and control patients was 2.20 (95% confidence interval [CI], 1.84–2.61, P<.001). After adjusting for age, sex, and comorbidities, RA patients were 2.06 times more likely to develop depressive disorders (95% CI, 1.73–2.44, P<.001) compared with the control patients. Hyperthyroidism (HR = 1.67) was an independent risk factor for depressive disorders in patients with RA.ConclusionsThe likelihood of developing depressive disorders is greater among RA patients than among patients without RA. Symptoms of depression should be sought in patients with RA.
Highlights
Rheumatoid arthritis (RA) is a systemic chronic autoimmune disorder affecting primarily cartilage and bone
For each cirrhotic patient included in the final cohort, 4 age, sex, and enrolment-date-matched control patients who were not diagnosed with rheumatoid arthritis or depressive disorder were randomly selected from the LHID 2005
The comorbidities, including hypertension, diabetes mellitus, dyslipidemia, congestive heart failure, hyperthyroidism, hypothyroidism, and cerebrovascular disease were more common in rheumatoid arthritis (RA) patients than control patients
Summary
Rheumatoid arthritis (RA) is a systemic chronic autoimmune disorder affecting primarily cartilage and bone. Despite of substantial advances in medical treatment, chronic pain, fatigue, and functional disability causes much psychosocial burden for these patients with RA [2,3]. Interest in the psychiatric aspects of rheumatoid arthritis has grown. Comorbid depression has been shown to independently increase disability and a low quality of life in patients with RA [14,15,16,17,18]. Depression has been demonstrated to be an independent risk factor for non-suicide mortality in patients with RA [19]. To evaluate the risk of depressive disorders among rheumatoid arthritis (RA) by using the Taiwan National Health Insurance Research Database (NHIRD)
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