ORIGINAL ARTICLE
Disability and patient's appraisal of general health contribute to depressed mood in rheumatoid arthritis in a large clinical study in Japan
Authors
Ayako Nakajima1, Shigeo Kamitsuji1, Akira Saito1, Eiichi Tanaka1, Katsuji Nishimura2, Naoshi Horikawa2, Norio Ozaki3, Taisuke Tomatsu1, Masako Hara1, Naoyuki Kamatani1 and Hisashi Yamanaka1
| (1) |
Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan |
| (2) |
Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan |
| (3) |
Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan |
Received:
11 January 2006
Accepted:
22 March 2006
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Abstract
The aim of this study was to evaluate the factors responsible for depressed mood in rheumatoid arthritis (RA). Clinical and laboratory measures were collected from 4558 RA patients enrolled in a large clinical cohort study for RA conducted at the Institute of Rheumatology, Tokyo Women's Medical University (IORRA study). A two-question depressed screening included in the U.S. Preventive Services Task Force recommendation were utilized to identify “depressed patients.” A total of 1875 (41.1%) were identified as “depressed patients” who presented with symptoms suggestive of depression. Patient's Visual Analog Scale (VAS) for general health (43.3 mm vs 24.6 mm, P < 0.0001) and pain (40.9 mm vs 23.8 mm, P < 0.0001) and the disability index scores measured by the Health Association Questionnaire (HAQ) (0.986 vs 0.574, P < 0.0001) were significantly higher in depressed patients than in nondepressed patients. The presence of three or more comorbidities (odds ratio [OR] 2.157, P < 0.0001), infection (OR 1.754, P < 0.0001), and joint surgery (OR 1.878, P < 0.0001) were significantly correlated with depressed mood in RA. The results of the Generalized Linear Model analysis showed that HAQ disability index (P < 0.0001) and patient's VAS for general health (P < 0.0001) were also strongly and significantly associated to the response variable “probability of depressed patients.” Patient appraisal of poor general health and greater disability were associated with depressed mood in RA.
Key words
Depression - Disability - General Health - Rheumatoid arthritis (RA) - Two-question screen |
