Factors Associated with Depressive State in Patients with Rheumatoid Arthritis

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  • Miwa Yusuke
    Division of Rheumatology, Department of Medicine, Showa University School of Medicine
  • Hosaka Michio
    Department of Psychosomatic Medicine, Katsuyama Clinic
  • Mitamura Yuko
    Department of Nursing, Showa University School of Nursing and Rehabilitation Sciences

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Other Title
  • 関節リウマチ患者の抑うつ状態と関連する因子の検討
  • カンセツ リウマチ カンジャ ノ ヨクウツ ジョウタイ ト カンレン スル インシ ノ ケントウ

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Abstract

<p>Background : Approximately 15% of patients with rheumatoid arthritis (RA) have depression. In previous studies, depressed mood and sleep disorders have been reported separately, and no studies have examined the factors that constitute depression. In addition, no studies have examined the relationship between these factors. This study investigated factors associated with depressive states in patients with RA.</p><p>Methods : One hundred and twenty-four patients with RA attending Showa University Hospital, who provided written consent to participate in the study, were included. Age, sex, body mass index, smoking history, hypertension, presence of diabetes, steroid use, methotrexate use, erythrocyte sedimentation rate, CRP levels, and serum MMP-3 levels were also investigated. The Simplified Disease Activity Index (SDAI) was used to assess disease activity in patients with RA. The Health Assessment Questionnaire Disability Index (HAQ-DI) was used to evaluate activities of daily living, and the Hamilton Depression Rating Scale (HAM-D) was used to assess depression. All patients were interviewed for HAM-D by the same interviewer, and the relationship between each item on the HAM-D and each index was examined.</p><p>Results : Forty-two patients (33.9%) reported experiencing a “depressed mood.” In contrast, a higher percentage of patients reported “anxiety somatic” (79, 63.7%), “somatic symptoms general” (69, 55.6%), “work and activities” (57, 46.0%), “hypochondriasis” (53, 42.7%), and “genital symptoms” (49, 39.5%). “Depressed mood” was correlated with SDAI (r=0.32, p＜0.001) and HAQ-DI (r=0.28, p=0.004), whereas “somatic symptoms general” was associated with SDAI (r=0.30, p＜0.001) and HAQ-DI (r=0.29, p＜0.001). “Anxiety somatic” was associated only with age (r=0.21, p=0.007), while the other factors showed no correlation.</p><p>Conclusions : A higher percentage of patients with RA reported “somatic symptoms” than “depressed mood” as a factor of depression. These factors were mildly correlated with RA disease activity and HAQ-DI.</p>

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