Association of depression in rheumatoid arthritis: a single centre experience

Dibyendu Mukherjee; Sandeep Lahiry; Rajasree Sinha

doi:10.18203/2320-6012.ijrms20173570

Authors

Dibyendu Mukherjee Department of General Medicine, KPC Medical College and Hospital, Kolkata, West Bengal, India http://orcid.org/0000-0003-3264-2924
Sandeep Lahiry Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India http://orcid.org/0000-0002-6919-0530
Rajasree Sinha Department of Pediatrics, Medical College and Hospital, Kolkata, West Bengal, India http://orcid.org/0000-0002-8937-0459

DOI:

https://doi.org/10.18203/2320-6012.ijrms20173570

Keywords:

Depression, Disability, Pain, Rheumatoid arthritis

Abstract

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 1^st January 2016 to 31^st 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 <0.01). The prevalence of depression in RA group 21% (95% CI 15.5-26.9%), which was significantly higher (p <0.01) compared to non-RA cohort (8%; 95% CI 4-11.9). The mean score of SRD were consistently higher in females with RA (p <0.01). Treatment-naïve patients had higher incidence of depression compared to patients on >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.

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Author Biographies

Dibyendu Mukherjee, Department of General Medicine, KPC Medical College and Hospital, Kolkata, West Bengal, India

Associate Professor
Department of Internal Medicine

Sandeep Lahiry, Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India

Postgraduate trainee

Department of Pharmacology

Rajasree Sinha, Department of Pediatrics, Medical College and Hospital, Kolkata, West Bengal, India

Post graduate trainee
Department of Pediatrics

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