Temporal associations between the different domains of rheumatoid arthritis disease activity and the onset of patient-reported depressive symptoms
UMass Chan Affiliations
Meyers Primary Care InstituteDepartment of Orthopedics and Physical Rehabilitation
Document Type
Journal ArticlePublication Date
2015-04-01Keywords
Immune System DiseasesMental and Social Health
Musculoskeletal Diseases
Psychiatry and Psychology
Rheumatology
Metadata
Show full item recordAbstract
BACKGROUND: Depression is a frequently occurring comorbid condition in patients with rheumatoid arthritis (RA), and research into the temporal relationships regarding its onset has mainly focused on functional status. The study aim was to examine temporal associations of the diverse measures of RA disease activity with incident self-reports of depressive symptoms. METHODS: RA patients from the Consortium of Rheumatology Researchers of North America (CORRONA) registry were utilized. Cox regression was used to assess the lagged time-varying association of RA disease activity with the incident onset of depressive symptoms as measured using a single-item depression question. Predictor variables included joint counts, global assessments, pain, function, serum biomarkers, and composite disease activity. Hazard ratios (HRs) comparing categorical quintiles were estimated with 95 % confidence intervals. RESULTS: Every metric of disease activity, except inflammatory markers, were significantly associated with the self-reported onset of depressive symptoms. Adjusted HRs comparing fifth quintiles to first quintiles were the following: CDAI = 2.3 [2.1-2.7]; pain = 2.3 [2.0-2.6]; SJC = 1.4 [1.4-1.6]. When examining successive self-reports (two consecutive), the magnitude of the associations greatly increased: CDAI = 3.6 [2.5-5.0]. CONCLUSIONS: The data suggest depressive symptom onset in RA patients is related to measures reported by the patient: pain, functional status, and global disease activity; and measures reported by providers, rather than biological markers. The magnitude of the associations, however, were greater for the patient-reported measures when compared to physician assessments, implying that patients' experience of their disease activity may be a precipitating factor of depression onset.Source
Clin Rheumatol. 2015 Apr;34(4):653-63. doi: 10.1007/s10067-014-2759-z. Epub 2014 Aug 27. Link to article on publisher's siteDOI
10.1007/s10067-014-2759-zPermanent Link to this Item
http://hdl.handle.net/20.500.14038/30393PubMed ID
25156674Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1007/s10067-014-2759-z