Rheumatoid arthritis patients more prone to depression, claims JAMA study

Rheumatoid arthritis (RA) is a prevalent autoimmune disease characterized by systemic inflammation. This condition may require lifelong treatment due to its chronic nature, which results in numerous comorbidities. Depression is one of the most common comorbidities in RA patients, with estimates of prevalence ranging from 14% to 48%, which is significantly higher than in the general population.

According to an original investigation on Psychiatry published in JAMA Network Open, clinicians should consistently screen RA patients for depression. It is important for assessment and providing comprehensive mental and physical health care.
Depression is a prevalent comorbidity among individuals with rheumatoid arthritis (RA), but there is limited data on the relationship between RA seropositivity and biologic agents with depression risk. This study aimed to investigate the risk of depression following an RA diagnosis in the South Korean population. This retrospective cohort study involved 38,487 rheumatoid arthritis (RA) patients, and a control group of 192,435 individuals matched 1:5 for age, sex, and index date. Data were obtained from the Korean National Health Insurance Service database. Participants were enrolled from 2010 to 2017 and followed up until 2019.
Key findings from the study are:
  • The study population included 71 % females.
  • A total of 27 063 participants, 20 641 controls and 6422 with RA developed depression.
  • RA patients had a 1.66-fold higher risk of depression than controls with an adjusted hazard ratio [aHR] of 1.66.
  • The SPRA and the SNRA group were associated with an increased depression risk with aHR of 1.64 and 1.73, respectively.
  • RA patients who used biologic or targeted synthetic DMARDs with aHR, 1.33, had a lower depression risk compared with those who were not exposed to these medicines. The aHR was 1.69
  • SPRA and SNRA were associated with a significantly higher risk of depression. This highlights the importance of early screening and intervention for mental health in RA patients.
Study limitations include a limited evaluation of RA severity, result distortion due to unmeasured factors, and lack of information.
We found a strong association between RA and increased depression risk, regardless of age, sex, behavioural factors, and RA serologic status, they said.
Reference:
Jeon KH, Han K, Jung J, et al. Rheumatoid Arthritis and Risk of Depression in South Korea. JAMA Netw Open. 2024;7(3):e241139. doi:10.1001/jamanetworkopen.2024.1139

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