In the primary care setting, patients with chronic inflammatory disorders were found to have a higher incidence of anxiety and depression, according to study results published in the Annals of the Rheumatic Diseases.

Researchers conducted a prospective cohort study of 180,163 patients with chronic inflammatory disorders who were paired with 358,544 healthy control patients based on several characteristics, including age, gender, practice, and index date. Cohort data were collected from the UK Clinical Practice Research Datalink, and participants were followed for a median duration of 4 years. Study exposures included 7 chronic inflammatory conditions, and a clinical diagnosis of anxiety or depression was the outcomes measured.

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After analysis, the researchers found that among participants, the highest incidence of anxiety and depression was found in patients with severe psoriasis (14 per 1000 person-years), and the lowest incidence was seen in patients with systemic vasculitis (9 per 1000 person-years). In addition, risk ratios of multiple anxiety and depression episodes were 16% higher in the chronic inflammatory group (hazard ratio, 1.16; 95% CI, 1.12-1.21; P <.001) vs the matched control group. The overall hazard ratio for depression was 1.90 (95% CI, 1.66-2.17; P <.001) for patients <40 years and 0.93 (95% CI, 0.90-1.09; P =.80) for patients ≥60 years.

One key limitation of the study was the observational study design.

“[These findings] may reflect the impact of the underlying disease on patients’ quality of life, although the precise mechanisms require further investigation,” the researchers wrote.

Reference

Dregan A, Matcham F, Harber-Aschan L, et al. Common mental disorders within chronic inflammatory disorders: a primary care database prospective investigation [published online March 7, 2019]. Ann Rheum Dis. doi: 10.1136/annrheumdis-2018-214676