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Association of Depression and Rheumatoid Arthritis

Received April 10, 2002; revision received Aug. 21, 2002; accepted Sept. 11, 2002. From the School of Psychiatry and Behavioural Science and the Arthritis Research Campaign, Epidemiology Research Unit, University of Manchester, Manchester, U.K. Address reprint requests to Dr. Dickens, Department of Psychiatry, Manchester Royal Infirmary, Rawnsley Bldg., Oxford Rd., Manchester M13 9WL, U.K.; c.dickens{at}man.ac.uk (e-mail).

This study assessed the relative strength of the association of physical characteristics and social stresses with a diagnosis of depression in patients with rheumatoid arthritis. Depression and social difficulties were assessed in 74 patients with rheumatoid arthritis by using standardized research interviews. Rheumatoid arthritis activity, damage related to rheumatoid arthritis, and subjective functional disability were assessed with well-validated methods. Twenty-nine patients (39.2%) were depressed. Compared to nondepressed patients, depressed patients had more marked social difficulties related to rheumatoid arthritis (72.4% versus 46.7%, respectively) and more marked social difficulties independent of rheumatoid arthritis (55.2% versus 31.1%, respectively). With logistic regression, social difficulties, independent of rheumatoid arthritis, was the only variable significantly associated with depression. Demographic characteristics and rheumatoid arthritis were not associated with a diagnosis of depression. Recognition by clinicians of the importance of social stresses, independent of disease state, should lead to more appropriate and specific psychological and social treatment of depression in rheumatoid arthritis.

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