According to data presented at the European League Against Rheumatism (EULAR) Congress held in Amsterdam, The Netherlands, June 13 to 16, 2018, rates of anxiety and depression in individuals with rheumatoid arthritis (RA) were correlated with measures of disease activity over the first year following diagnosis.1
“These results confirm both depression and anxiety as significant comorbidities at the time of rheumatoid arthritis diagnosis,” according to Professor Thomas Dörner, MD, chairperson of the Abstract Selection Committee, EULAR. “It is interesting to see [that] the changes in anxiety and depression scores appear in tandem with [changes in] disease activity over time, which requires further investigation.”
In order to examine the frequency of anxiety and depression in patients with early RA and over time and to assess associations with epidemiologic, socioeconomic, and disease-related factors, researchers examined data from 848 patients from the Scottish Early Rheumatoid Arthritis (SERA) inception cohort, which consisted of newly diagnosed patients with RA (fulfilling American College of Rheumatology/EULAR 2010 criteria) with follow-up every 6 months.
At baseline and at follow-up, pre-specified clinical, laboratory, and psychosocial features, including anxiety and depression scores (measured by the Hospital Anxiety and Depression Scale; score range: 0 to 21 for each), were recorded. To examine the nature and magnitude of associations, non-parameteric tests and logistic regression models were used.
One year after diagnosis, there were significant reductions in anxiety from 19.0% to 13.4% (P =.004) and depression from 12.2% to 8.2% (P =.01). This was correlated with an observed decrease in disease activity, and both depression and anxiety scores demonstrated a significant correlation with disease activity scores (DAS28) at baseline, 6 months, and 12 months (P <.0001). Change in DAS28 was also significantly correlated with change in both depression and anxiety scores at 6 and 12 months.
For anxiety scores, statistically significant associations were found with female gender, younger age, and patient global assessment score (PGA) at baseline. At 6 and 12 months, a significant association was demonstrated between anxiety scores and low body mass index, patient global assessment score (PGA), and baseline anxiety scores.
For depression scores, significant associations were found with PGA at baseline. At 6 and 12 months, depression score was significantly associated with PGA and C-reactive protein levels, as well as baseline depression and anxiety scores.
“Our results demonstrate a number of interesting associations with socioeconomic and other variables,” said study investigator Dr George Fragoulis, honorary research fellow at the University of Glasgow in Scotland. “Most interestingly, C-reactive protein, which is a blood test marker for inflammation, was highly associated with depression but not anxiety at all time points. This provides further support to compelling data linking inflammation and depression.”
- Fragoulis GE, Cavanagh J, Derakhshan MH, et al. Depression and anxiety in an early rheumatoid arthritis inception cohort. Associations with epidemiological, socioeconomic and disease features. Presented at: European League Against Rheumatism (EULAR) Congress 2018; June 13-16, 2018; Amsterdam, The Netherlands. Abstract OP0350.
- Rates of depression and anxiety may correlate with disease activity in early rheumatoid arthritis [press release]. European League Against Rheumatism (EULAR) Congress 2018; June 13-16, 2018; Amsterdam, The Netherlands. Published June 15, 2018. www.eurekalert.org/pub_releases/2018-06/elar-rod061418.php. Accessed June 27, 2018.