Abstract
Background. Depression is a common disorder in rheumatoid arthritis (RA) patients and can affect clinical outcomes. This study was conducted to determine the prevalence of depression and its relationship with disease activity in RA patients.
Methods. In this cross-sectional study, 144 patients with RA were recruited from the Rheumatology Outpatients Clinic, Mostafa Khomeini Hospital Ilam, and were examined for disease activity and depression symptoms. Disease activity was assessed by DAS28 using laboratory tests and physical examination. The Beck self-report questionnaire was used for measuring depression disorder. Data were analyzed using the linear regression models in STATA 14 software.
Results. The prevalence of depression in the sample was 61%. Multivariate analyses showed that patients with severe disease activity faced a significantly greater risk of depression compared to those with mild disease activity. Average levels increased by about 12.43 points in depression for patients with severe disease activity compared to those with mild disease activity. This association was statistically significant after adjusting for the model's other predictors (P<0.001). Furthermore, predicted models showed that the probability of depression increased with age and disease duration in patients with severe activity.
Conclusion. Considering the relationship between depression and severe RA disease activity, the need to screen RA patients in terms of depression disorder and pay attention to comprehensive mental and physical care and cure for better clinical outcomes seems necessary.
Practical Implications. Severe disease activity in RA may have been influenced by a psychological phenomenon such as depression; therefore, it was suggested that depression, as one of the diseases worsening the RA symptoms, should be screened and evaluated. It was also recommended that a comprehensive and multidisciplinary approach should be adopted by seeking assistance from psychiatric and psychological specialists in RA disease management.