The effect of depression and related psychosocial factors on disease activity in rheumatoid arthritis

Abstract

Introduction: Rheumatoid arthritis is one of the most common inflammatory chronic diseases worldwide. Depression is common in patients with rheumatoid arthritis. The relationship between depression and rheumatoid arthritis is a matter of curiosity, and it is thought that there is a bidirectional interaction between them. Depression is an important health problem that requires treatment. Therefore, it is essential to determine the conditions that call for more attention in terms of depression when following rheumatoid arthritis patients in primary care.Methods: Patients who applied to the rheumatology outpatient clinic, followed up for at least 1 year, and were diagnosed with rheumatoid arthritis according to the American College of Rheumatology (ACR) criteria were consecutively invited to the study. A total of 110 people, 18 men and 92 women, accepted the invitation. Beck Depression Inventory (BDI), Health Assessment Questionnaire (HAQ), and visual analogue scale (VAS) were filled together with the questionnaire developed by the researcher. In the joint examination of the patients, the number of tender joints and swollen joints were noted. Disease Activity Score (DAS28) was calculated and noted by measuring C Reactive Protein and erythrocyte sedimentation rates (ESR) in earlier tests performed on the patients. Rheumatoid factor status was recorded at the time of diagnosis or by checking the follow-up records.Results: In rheumatoid arthritis (RA) patients, the BDI score was higher in people with other chronic diseases and those who felt the need to apply to a psychiatry clinic. The BDI score was higher in patients with other chronic diseases and those who felt the need to apply to a psychiatry clinic for rheumatoid arthritis. RA patients with high BDI scores also had high DAS28 and HAQ scores. In addition, disease activity was significantly correlated with RF positivity.Conclusion: Rheumatoid arthritis patients should be evaluated for depression. Depression evaluation should be done more carefully in cases with high disease activity, other chronic diseases, and those who feel the need to apply to a psychiatry clinic.