Depression May Worsen QOL in Rheumatoid Arthritis Patients

Patients with coexisting rheumatoid arthritis (RA) and depression tend to have higher disease activity and lower quality of life than patients without depression, according to a review published online December in the International Journal of Rheumatic Diseases.

Lijuan Zhang, from the Shanghai Jiao Tong University School of Medicine, and colleagues conducted a systematic literature review to identify studies evaluating the impact of depression on pain, disease activity, functional disability, and quality of life among patients with RA using the Short Form-36 questionnaire (SF-36) scoring system.

Based on seven studies (1,078 patients), the researchers found that the total Disease Activity Score in 28 joints was significantly higher in patients with depression than in patients without depression (standardized mean difference [SMD], 0.47; 95 percent confidence interval [CI], 0.10 to 0.85; P = 0.01). Additionally, all SF-36 dimensions (physical function, role-physical function, role-emotional function, vitality, mental health, social function, body pain, general health, physical component scale, mental component scale) were lower in patients with depression versus groups without depression. However, in a meta-analysis, there was no significant difference between patients with and without depression with regard to pain (SMD, 0.57; 95 percent CI, −0.03 to 1.17; P = 0.06) or functional disability (SMD, 0.48; 95 percent CI, −0.03 to 0.99; P = 0.43).

"In RA, the association between depression and treatment outcomes such as pain, disease activity, functional disability, and quality of life has not been widely explored," the authors write.

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