The prevalence of anxiety and depression is higher among adults with arthritis compared with the general population, according to survey data published in the Morbidity and Mortality Weekly Report.
The National Health Interview Survey (NHIS) is an annual, cross-sectional survey that captures nationally representative data from the civilian US population. To estimate the national prevalence of anxiety and depression among adults (≥18 years) with arthritis, the Centers for Disease Control and Prevention abstracted NHIS response data from 2015 to 2017. Subsequent analyses combined NHIS data for 2015, 2016, and 2017 from the Sample Adult component of the survey (n=93,442). A randomly selected subset of sample adults (n=46,742) completed the Adult Functioning and Disability supplement during the 3-year period. The supplement captured any arthritis diagnosis as well as anxious and depressive symptomatology. Age-standardized prevalence figures were calculated using the 2000 projected US population data for each age demographic.
Age-standardized prevalence rates of anxiety and depression symptoms among adults with arthritis were 22.5% (95% CI, 20.8%-24.3%) and 12.1% (95% CI, 10.8%-13.4%), respectively. Prevalences among adults without arthritis were 10.7% (95% CI, 10.2%-11.2%) and 4.7% (95% CI, 4.4%-5.0%), respectively. For individuals with arthritis, the prevalences of anxiety and depression were higher among those aged 18 to 44 years compared with those aged ≥65 years. Prevalence rates were also higher among those who reported chronic pain, activity limitations related to arthritis, or any co-occurring chronic condition. In contrast, patients with arthritis who reported aerobic physical activity had lower rates of anxiety and depression. Among patients with arthritis, fewer reported taking medication to manage symptoms of anxiety (44.3%) compared with medication to manage symptoms of depression (57.7%). Similarly, fewer reported seeing a professional in the past year for anxiety symptoms (34.3%) than for depression symptoms (42.8%).
Anxiety and depression occurred with higher prevalence in women and among those who were unemployed, unable to work, or disabled. In addition, individuals who reported a sexual identity other than heterosexual were at higher risk for depression and anxiety compared with those who identified as heterosexual. Adults with higher educational levels and greater income had reduced prevalence rates of depression and anxiety. Those who reported current smoking had higher prevalences compared with those who never smoked.
These data suggest a high burden of depression and anxiety symptoms among patients with arthritis. This report further highlights specific high-risk demographics among those with arthritis, including those aged 18 to 44 years, those who are unemployed or unable to work, and those who report chronic pain or activity limitations. Although these high-risk demographics may require targeted intervention for depression and anxiety, all adults with arthritis may benefit from mental health screening. In addition, programs that encourage physical activity and provide education on self-management may serve as effective nonpharmacologic interventions for depression and anxiety among patients with arthritis.
Guglielmo D, Hootman JM, Boring MA, et al. Symptoms of anxiety and depression among adults with arthritis — United States, 2015–2017. MMWR Morb Mortal Wkly Rep. 2018;67:1081-1087.