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Rheumatoid arthritis linked to higher depression risk


Depression is higher in men and women with rheumatoid arthritis, and may increase mortality in this population, according to a study.

Researchers used data collected from annual telephone surveys of 530 participants with RA who live in Northern California to assess symptoms of depression and the potential impact of depression in this population. Participants were designated as depressed if they scored greater than five on the Geriatric Depression Scale, a standardized measurement tool.

To be eligible, participants had to undergo an interview in either 2002 or 2003 with at least one follow-up interview. They were then followed until 2009. Participants’ average age was 60 and 84% were female, with an average disease duration of 19 years.

During the study, 63 participants died. Higher depression scores were associated with mortality in the study, said Patricia Katz, PhD, a study investigator and professor of medicine and health policy at the University of California, San Francisco.

“People with rheumatoid arthritis who were depressed were more likely to die than those with RA who were not depressed,” Katz said in a news release. “We found that seemed to be particularly true for the men. The risk of death for depressed men was twice that for depressed women.”

Overall, men in the study had a higher mortality risk than women, after controlling for other variables. This finding was true for both depressed and non-depressed individuals. Meanwhile, a baseline history of depression by the Geriatric Depression Scale resulted in approximately twice the mortality for both genders.

When the increased risk associated with gender was combined with the risk associated with depression, men in the study whose scores indicated depression were five times as likely to die as women with RA whose scores indicated they were not depressed.

Men and women with increases in depressive symptoms had a higher mortality risk even if they did not score high enough on the Geriatric Depression Scale to be considered depressed, Katz said. “An increase in the depressive symptom score, even if they didn’t cross over that critical line to overt depression, was still associated with a higher level of mortality.”

The study’s findings suggest that depression and depressive symptoms are a significant risk factor for mortality in RA, although not necessarily a part of the disease process, Katz said. “Patients need to be made aware that depression is something to pay attention to in RA, and they need to tell their physician about it. Rheumatologists and other healthcare providers need to be aware of the problem of depression in the clinical setting.”

The study was presented at the American College of Rheumatology’s annual meeting Nov. 14-19 in Washington, D.C.


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