Publication:

Association of depression in rheumatoid arthritis: a single centre experience

Background To identify clinically important predictors of Rheumatoid Arthritis (RA) associated self-reported depression (SRD) in Eastern India.

Methods A questionnaire-based study was conducted among adult RA patients attending Rheumatology clinic at KPC Medical College and Hospital, Kolkata between 1st January 2016 to 31st December 2016.

Results A total of 246 questionnaires were returned (responder rate: 64.9%). 180 (47.49%) completed pairs were selected and were subsequently analyzed. Most RA patients had disease >5 years (61%), belonged to rural background (>50%) and middle-income group (43.3%). 89 patients (49.4%) reported having another major disease. Nearly 13% (working age group) claimed to be unemployed due to ‘health reasons.’ Unconditional logistic regression revealed that SRD was also related to work status (p 3 months of DMARDs (38% versus 17%; p<0.05). Moreover, SRD was higher in presence of co-morbidities, highest being in cancer (HR: 2.39, 95% CI 1.41-4.18), followed by chronic renal disease (HR: 2.26, 95% CI 1.05-4.12) and stroke (HR: 1.79, 95% CI 1.02-2.92).

Conclusions Depression is significantly higher patients with early RA. Pain level and work status is related, and may implicate a vicious circle. Early psychiatric evaluation may improve pain scores in RA.