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

Year 2022, Volume: 7 Issue: 2, 49 - 54, 31.05.2022

Murat Tekin Aytekin Oğuz

https://doi.org/10.22391/fppc.1027441

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.

Keywords

Rheumatoid arthritis Depression visual analogue scale chronic disease

Thanks

We would like to express our endless thanks to Dr. Fusun MORAL OGUZ, who provided all kinds of help wholeheartedly during the data collection phase and made us feel her support constantly.

References

  • 1. Giannini D, Antonucci M, Petrelli F, Bilia S, Alunno A, Puxeddu I. One year in review 2020: pathogenesis of rheumatoid arthritis. Clin Exp Rheumatol. 2020;38(3):387-97. https://pubmed.ncbi.nlm.nih.gov/32324123/
  • 2. Wasserman A. Rheumatoid arthritis: common questions about diagnosis and management. Am Fam Physician. 2018;97(7):455-62. https://pubmed.ncbi.nlm.nih.gov/29671563/
  • 3. World Health Organization. (‎2017)‎. Depression and other common mental disorders: global health estimates. World Health Organization. https://www.who.int/mental_health/management/depression/prevalence_global_health_estimates/en/ (Access Date: May 27, 2022)
  • 4. Kalaca S. Mental Health Problems-Short Questionnaire. In: B Unal, Ergor G, editors. Turkey chronic diseases and risk factors frequency study. Ministry of health publication no:909. Ankara 2013. p. 235. https://sbu.saglik.gov.tr/ekutuphane/kitaplar/khrfat.pdf (Access Date: May 27, 2022)
  • 5. Anber T, Akar T, Altun F. [Depression and Community Mental Health]. SOYD. 2021;2(2):99-103. https://doi.org/10.54247/SOYD.2021.30
  • 6. DeJean D, Giacomini M, Vanstone M, Brundisini F. Patient experiences of depression and anxiety with chronic disease: a systematic review and qualitative meta-synthesis. Ont Health Technol Assess Ser. 2013;13(16):1-33. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3817854/
  • 7. Matcham F, Rayner L, Steer S, Hotopf M. The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology (Oxford). 2013;52(12):2136-48. https://doi.org/10.1093/rheumatology/ket169
  • 8. Fakra E, Marotte H. (2021). Rheumatoid arthritis and depression. Joint bone spine 2021;88(5):105200. https://doi.org/10.1016/j.jbspin.2021.105200
  • 9. ACR; Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Rheum 1988;31:315-24 https://onlinelibrary.wiley.com/doi/epdf/10.1002/art.1780310302
  • 10. Hisli N: [The validity and reliability of the Beck Depression Inventory for university students]. J Psychology 1989;7(23):3-13 https://www.psikolog.org.tr/tr/yayinlar/dergiler/1031828/tpd1300443319890000m000366.pdf (Access Date: May 27, 2022)
  • 11. Kucukdeveci AA, Sahin H, Ataman S, Griffiths B, Tennant A. Issues in cross-cultural validity: example from the adaptation, reliability, and validity testing of a Turkish version of the Stanford Health Assessment Questionnaire. Arthritis Rheum. 2004;51(1):14-9. https://doi.org/10.1002/art.20091
  • 12. Aletaha D, Ward MM, Machold KP, Nell VP, Stamm T, Smolen JS. Remission and active disease in rheumatoid arthritis: defining criteria for disease activity states. Arthritis Rheum. 2005;52(9):2625-36. https://doi.org/10.1002/art.21235
  • 13. Vallerand IA, Lewinson RT, Frolkis AD, Lowerison MW, Kaplan GG, Swain MG, et al. Depression as a risk factor for the development of rheumatoid arthritis: a population-based cohort study. RMD Open. 2018;4(2):e000670. https://doi.org/10.1136/rmdopen-2018-000670
  • 14. Matcham F, Rayner L, Steer S, Hotopf M. The prevalence of depression in rheumatoid arthritis: a systematic review and meta‐analysis. Rheumatology (Oxford) 2013;52:2136‐48. https://doi.org/10.1093/rheumatology/ket169
  • 15. Abdel-Ahad P, El Chammai M, Fneich A, Issa R, Kabbara W, Richa S. Les manifestations psychiatriques dans la polyarthrite rhumatoïde [Psychiatric aspects of rheumatoid arthritis: Review of literature]. Encephale. 2016;42(2):172-6. https://doi.org/10.1016/j.encep.2015.12.008
  • 16. Yurdakul FG, Garip Cimen Y, Kilicarslan A, Caliskan Uckun A, Bodur H. Depression in rheumatoid arthritis: association with quality of life, function and disease activity . Ankara Med J 2018;18(3),337-44. https://doi.org/10.17098/amj.461385
  • 17. Dalrymple, K. L., & Zimmerman, M. Treatment-seeking for social anxiety disorder in a general outpatient psychiatry setting. Psychiatry Res 2011;187(3), 375–81. https://doi.org/10.1016/j.psychres.2011.01.004
  • 18. Zhang L, Cai P, Zhu W. Depression has an impact on disease activity and health-related quality of life in rheumatoid arthritis: A systematic review and meta-analysis. Int J Rheum Dis. 2020;23(3):285-93. https://doi.org/10.1111/1756-185x.13774
  • 19. Peck JR, Smith TW, Ward JR, Milano R. Disability and depression in rheumatoid arthritis. A multi-trait, multi-method investigation. Arthritis Rheum. 1989;32(9):1100-6. https://onlinelibrary.wiley.com/doi/epdf/10.1002/anr.1780320908 (Access Date: May 27, 2022)
  • 20. Gautam S, Tolahunase M, Kumar U, Dada R. ‘Impact of yoga based mind-body intervention on systemic inflammatory markers and co-morbid depression in active rheumatoid arthritis patients: a randomized controlled trial’. 2019;37(1):41 – 59. https://doi.org/10.3233/RNN-180875
  • 21. Fragoulis GE, Cavanagh J, Tindell A, Derakhshan M, Paterson C, Porter D, et al. Depression and anxiety in an early rheumatoid arthritis inception cohort. associations with demographic, socioeconomic and disease features. RMD Open. 2020;6:e001376. http://dx.doi.org/10.1136/rmdopen-2020-001376
  • 22. Jamshidi AR, Banihashemi AT, Paragomi P, Hasanzadeh M, Barghamdi M, Ghoroghi S. Anxiety and depression in rheumatoid arthritis: an epidemiologic survey and investigation of clinical correlates in Iranian population. Rheumatol Int. 2016;36(8):1119-25. https://doi.org/10.1007/s00296-016-3493-4
  • 23. Arman F, Shakeri H, Jalilian F, Ebrahimi E, Shakeri J, Farnia V. the influence of pain, weakness and rheumatoid factor status on depression incidence among Iranian patients with rheumatoid arthritis. Iran J Psychiatry Behav Sci. 2016;10(3):e3894. https://doi.org/10.17795/ijpbs-3894
  • 24. Tillmann T, Krishnadas R, Cavanagh J, Petrides KV. Possible rheumatoid arthritis subtypes in terms of rheumatoid factor, depression, diagnostic delay and emotional expression: an exploratory case-control study. Arthritis Res Ther. 2013;15(2):R45. https://doi.org/10.1186/ar4204
  • 25. Yakar B, Ertekin YH. Screening cardiovascular risk in patients with high depression scores. Pak J Med Sci. 2018;34(3):610-615. https://doi.org/10.12669/pjms.343.14560
  • 26. Behnam B, Moghimi J, Ghorbani R, Ghahremanfard F. "The frequency and major determinants of depression in patients with rheumatoid arthritis: romatoid artrit hastalarinda depresyonun sikligi ve ana belirleyicileri." Turkish Journal of Rheumatology, vol. 2013;28(1):32-37 https://archivesofrheumatology.org/full-text/496/tur (Access Date: May 27, 2022)

Depresyon ve ilişkili psikososyal faktörlerin romatoid artrit aktivitesine etkisi

Year 2022, Volume: 7 Issue: 2, 49 - 54, 31.05.2022

Murat Tekin Aytekin Oğuz

https://doi.org/10.22391/fppc.1027441

Abstract

Giriş: Romatoid artrit dünyada sık görülen inflamatuvar kronik hastalıklardandır. Romatoid artrit hastalarında depresyon sık rastlanır. Depresyon ile romatoid artritin ilişkisi merak konusu olup, aralarında çift yönlü bir etkileşim olduğu düşünülmektedir. Depresyon tedavi edilmesi gereken önemli bir sağlık sorunudur. Birinci basamakta romatoid artrit hastalarını takip ederken depresyon açısından daha dikkatli olunması gereken durumları belirlemek önemlidir.

Yöntem: Romatoloji polikliniğine başvuran en az 1 yıldır takipli ve Amerikan Romatizma Cemiyeti (ACR) kriterlerine göre romatoid artrit tanısı almış hastalar sırasıyla çalışmaya davet edildi. Daveti kabul eden 18’i erkek, 92’si kadın toplam 110 kişiydi. Araştırmacı tarafından geliştirilen anket formunun yanında Beck Depresyon Envanteri (BDE), Sağlık Değerlendirme Anketi (HAQ) ve görsel analog skala (VAS) dolduruldu. Hasta eklem muayenesinde hassas eklem sayısı ve şiş eklem sayısı not edildi. Hastanın yaptırmış olduğu tetkiklerdeki C reaktif protein, eritrosit sedimantasyon hızı (ESH) kaydedilerek Hastalık Aktivite Skoru (DAS28) hesaplandı ve not edildi. Romatoid faktör durumu hastanın tanı esnasında ya da sonraki tetkiklerine bakılarak kaydedildi.

Bulgular: Romatoid artrit (RA) hastalarında ek kronik hastalığı olanlarda, psikiyatri kliniğine başvuru ihtiyacı hissedenlerde BDE skoru daha yüksek bulundu. Ayrıca BDE skoru yüksek olan RA hastalarının DAS28 ve HAQ skorlarının da yüksek olduğu saptandı. Hastalık aktivitesinin ayrıca RF pozitifliği ile istatistiksel olarak anlamlı bir ilişki içinde olduğu görüldü.

Sonuç: Romatoid artrit hastaları depresyon açısından değerlendirilmelidir. Hastalık aktivitesi yüksek olan, ek hastalığı olan, psikiyatri kliniğine başvurma ihtiyacı hisseden olgularda depresyon değerlendirmesi daha hassasiyetle yapılmalıdır. 

Keywords

Romatoid artrit Depresyon Görsel Analog Skala Kronik Hastalık

References

  • 1. Giannini D, Antonucci M, Petrelli F, Bilia S, Alunno A, Puxeddu I. One year in review 2020: pathogenesis of rheumatoid arthritis. Clin Exp Rheumatol. 2020;38(3):387-97. https://pubmed.ncbi.nlm.nih.gov/32324123/
  • 2. Wasserman A. Rheumatoid arthritis: common questions about diagnosis and management. Am Fam Physician. 2018;97(7):455-62. https://pubmed.ncbi.nlm.nih.gov/29671563/
  • 3. World Health Organization. (‎2017)‎. Depression and other common mental disorders: global health estimates. World Health Organization. https://www.who.int/mental_health/management/depression/prevalence_global_health_estimates/en/ (Access Date: May 27, 2022)
  • 4. Kalaca S. Mental Health Problems-Short Questionnaire. In: B Unal, Ergor G, editors. Turkey chronic diseases and risk factors frequency study. Ministry of health publication no:909. Ankara 2013. p. 235. https://sbu.saglik.gov.tr/ekutuphane/kitaplar/khrfat.pdf (Access Date: May 27, 2022)
  • 5. Anber T, Akar T, Altun F. [Depression and Community Mental Health]. SOYD. 2021;2(2):99-103. https://doi.org/10.54247/SOYD.2021.30
  • 6. DeJean D, Giacomini M, Vanstone M, Brundisini F. Patient experiences of depression and anxiety with chronic disease: a systematic review and qualitative meta-synthesis. Ont Health Technol Assess Ser. 2013;13(16):1-33. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3817854/
  • 7. Matcham F, Rayner L, Steer S, Hotopf M. The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology (Oxford). 2013;52(12):2136-48. https://doi.org/10.1093/rheumatology/ket169
  • 8. Fakra E, Marotte H. (2021). Rheumatoid arthritis and depression. Joint bone spine 2021;88(5):105200. https://doi.org/10.1016/j.jbspin.2021.105200
  • 9. ACR; Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Rheum 1988;31:315-24 https://onlinelibrary.wiley.com/doi/epdf/10.1002/art.1780310302
  • 10. Hisli N: [The validity and reliability of the Beck Depression Inventory for university students]. J Psychology 1989;7(23):3-13 https://www.psikolog.org.tr/tr/yayinlar/dergiler/1031828/tpd1300443319890000m000366.pdf (Access Date: May 27, 2022)
  • 11. Kucukdeveci AA, Sahin H, Ataman S, Griffiths B, Tennant A. Issues in cross-cultural validity: example from the adaptation, reliability, and validity testing of a Turkish version of the Stanford Health Assessment Questionnaire. Arthritis Rheum. 2004;51(1):14-9. https://doi.org/10.1002/art.20091
  • 12. Aletaha D, Ward MM, Machold KP, Nell VP, Stamm T, Smolen JS. Remission and active disease in rheumatoid arthritis: defining criteria for disease activity states. Arthritis Rheum. 2005;52(9):2625-36. https://doi.org/10.1002/art.21235
  • 13. Vallerand IA, Lewinson RT, Frolkis AD, Lowerison MW, Kaplan GG, Swain MG, et al. Depression as a risk factor for the development of rheumatoid arthritis: a population-based cohort study. RMD Open. 2018;4(2):e000670. https://doi.org/10.1136/rmdopen-2018-000670
  • 14. Matcham F, Rayner L, Steer S, Hotopf M. The prevalence of depression in rheumatoid arthritis: a systematic review and meta‐analysis. Rheumatology (Oxford) 2013;52:2136‐48. https://doi.org/10.1093/rheumatology/ket169
  • 15. Abdel-Ahad P, El Chammai M, Fneich A, Issa R, Kabbara W, Richa S. Les manifestations psychiatriques dans la polyarthrite rhumatoïde [Psychiatric aspects of rheumatoid arthritis: Review of literature]. Encephale. 2016;42(2):172-6. https://doi.org/10.1016/j.encep.2015.12.008
  • 16. Yurdakul FG, Garip Cimen Y, Kilicarslan A, Caliskan Uckun A, Bodur H. Depression in rheumatoid arthritis: association with quality of life, function and disease activity . Ankara Med J 2018;18(3),337-44. https://doi.org/10.17098/amj.461385
  • 17. Dalrymple, K. L., & Zimmerman, M. Treatment-seeking for social anxiety disorder in a general outpatient psychiatry setting. Psychiatry Res 2011;187(3), 375–81. https://doi.org/10.1016/j.psychres.2011.01.004
  • 18. Zhang L, Cai P, Zhu W. Depression has an impact on disease activity and health-related quality of life in rheumatoid arthritis: A systematic review and meta-analysis. Int J Rheum Dis. 2020;23(3):285-93. https://doi.org/10.1111/1756-185x.13774
  • 19. Peck JR, Smith TW, Ward JR, Milano R. Disability and depression in rheumatoid arthritis. A multi-trait, multi-method investigation. Arthritis Rheum. 1989;32(9):1100-6. https://onlinelibrary.wiley.com/doi/epdf/10.1002/anr.1780320908 (Access Date: May 27, 2022)
  • 20. Gautam S, Tolahunase M, Kumar U, Dada R. ‘Impact of yoga based mind-body intervention on systemic inflammatory markers and co-morbid depression in active rheumatoid arthritis patients: a randomized controlled trial’. 2019;37(1):41 – 59. https://doi.org/10.3233/RNN-180875
  • 21. Fragoulis GE, Cavanagh J, Tindell A, Derakhshan M, Paterson C, Porter D, et al. Depression and anxiety in an early rheumatoid arthritis inception cohort. associations with demographic, socioeconomic and disease features. RMD Open. 2020;6:e001376. http://dx.doi.org/10.1136/rmdopen-2020-001376
  • 22. Jamshidi AR, Banihashemi AT, Paragomi P, Hasanzadeh M, Barghamdi M, Ghoroghi S. Anxiety and depression in rheumatoid arthritis: an epidemiologic survey and investigation of clinical correlates in Iranian population. Rheumatol Int. 2016;36(8):1119-25. https://doi.org/10.1007/s00296-016-3493-4
  • 23. Arman F, Shakeri H, Jalilian F, Ebrahimi E, Shakeri J, Farnia V. the influence of pain, weakness and rheumatoid factor status on depression incidence among Iranian patients with rheumatoid arthritis. Iran J Psychiatry Behav Sci. 2016;10(3):e3894. https://doi.org/10.17795/ijpbs-3894
  • 24. Tillmann T, Krishnadas R, Cavanagh J, Petrides KV. Possible rheumatoid arthritis subtypes in terms of rheumatoid factor, depression, diagnostic delay and emotional expression: an exploratory case-control study. Arthritis Res Ther. 2013;15(2):R45. https://doi.org/10.1186/ar4204
  • 25. Yakar B, Ertekin YH. Screening cardiovascular risk in patients with high depression scores. Pak J Med Sci. 2018;34(3):610-615. https://doi.org/10.12669/pjms.343.14560
  • 26. Behnam B, Moghimi J, Ghorbani R, Ghahremanfard F. "The frequency and major determinants of depression in patients with rheumatoid arthritis: romatoid artrit hastalarinda depresyonun sikligi ve ana belirleyicileri." Turkish Journal of Rheumatology, vol. 2013;28(1):32-37 https://archivesofrheumatology.org/full-text/496/tur (Access Date: May 27, 2022)
There are 26 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Murat Tekin 0000-0001-6841-3045

Aytekin Oğuz 0000-0002-2595-5167

Publication Date May 31, 2022
Submission Date November 23, 2021
Acceptance Date March 17, 2022
Published in Issue Year 2022Volume: 7 Issue: 2

Cite

APA Tekin, M., & Oğuz, A. (2022). The effect of depression and related psychosocial factors on disease activity in rheumatoid arthritis. Family Practice and Palliative Care, 7(2), 49-54. https://doi.org/10.22391/fppc.1027441
AMA Tekin M, Oğuz A. The effect of depression and related psychosocial factors on disease activity in rheumatoid arthritis. Fam Pract Palliat Care. May 2022;7(2):49-54. doi:10.22391/fppc.1027441
Chicago Tekin, Murat, and Aytekin Oğuz. “The Effect of Depression and Related Psychosocial Factors on Disease Activity in Rheumatoid Arthritis”. Family Practice and Palliative Care 7, no. 2 (May 2022): 49-54. https://doi.org/10.22391/fppc.1027441.
EndNote Tekin M, Oğuz A (May 1, 2022) The effect of depression and related psychosocial factors on disease activity in rheumatoid arthritis. Family Practice and Palliative Care 7 2 49–54.
IEEE M. Tekin and A. Oğuz, “The effect of depression and related psychosocial factors on disease activity in rheumatoid arthritis”, Fam Pract Palliat Care, vol. 7, no. 2, pp. 49–54, 2022, doi: 10.22391/fppc.1027441.
ISNAD Tekin, Murat - Oğuz, Aytekin. “The Effect of Depression and Related Psychosocial Factors on Disease Activity in Rheumatoid Arthritis”. Family Practice and Palliative Care 7/2 (May 2022), 49-54. https://doi.org/10.22391/fppc.1027441.
JAMA Tekin M, Oğuz A. The effect of depression and related psychosocial factors on disease activity in rheumatoid arthritis. Fam Pract Palliat Care. 2022;7:49–54.
MLA Tekin, Murat and Aytekin Oğuz. “The Effect of Depression and Related Psychosocial Factors on Disease Activity in Rheumatoid Arthritis”. Family Practice and Palliative Care, vol. 7, no. 2, 2022, pp. 49-54, doi:10.22391/fppc.1027441.
Vancouver Tekin M, Oğuz A. The effect of depression and related psychosocial factors on disease activity in rheumatoid arthritis. Fam Pract Palliat Care. 2022;7(2):49-54.
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Family Practice and Palliative Care       ISSN 2458-8865       E-ISSN 2459-1505