Rheumatoid Collagen Disease-associated Depression and Anxiety

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

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Other Title
  • 身体疾患にともなう抑うつ，不安
  • 身体疾患にともなう抑うつ,不安 : リウマチ膠原病にともなう抑うつ,不安
  • シンタイ シッカン ニ トモナウ ヨクウツ,フアン : リウマチコウゲンビョウ ニ トモナウ ヨクウツ,フアン
  • ―リウマチ膠原病にともなう抑うつ，不安―

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Abstract

<p>Certain chronic diseases, such as rheumatoid arthritis, have been reported to be associated with depression. The rate of rheumatoid arthritis varies widely from 7 to 75%, depending on the report. Most studies were based on questionnaires. The questionnaires used were diverse and not standardized and included the SDS, CES-D, HADS, BDI, PHQ-9, and HAM-D. There are questions as to which questionnaire is the most appropriate, where the cutoff value should be set, and the validity of the questionnaire method in comparison with structured interviews conducted by psychiatrists. Differences in the backgrounds of the study participants (time period, country, age, sex, race, and duration of illness) also make a difference. In addition, because the depression questionnaire included questions about physical symptoms, care is needed when interpreting the results if a patient has an underlying disease. However, treatment methods for rheumatoid arthritis have greatly progressed over time, and it is expected that as the disease activity of rheumatoid arthritis improves, the concomitant depressive state will also improve, and the rate of depression will decrease ; however, this warrants further validation. Complications of other collagen diseases, especially Sjögren’s syndrome and fibromyalgia, can exacerbate depression. There are mixed reports on anxiety, with some reporting an intensification of rheumatoid arthritis, while others reporting no change ; the results vary depending on the assessment method used. This article summarizes these issues and discusses future directions.</p>

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