Can We Predict Depression in Patients with Rheumatoid Arthritis?

Objectives: Depression and rheumatoid arthritis (RA) are disabling conditions that, if untreated, are associated with high morbidity and mortality. Depression is common in RA patients. The aims of this study were to evaluate whether depression could be predicted in RA patients at a tertiarycare center and to determine the clinical factors associated with the occurrence of depression in RA patients. Design: Cross-sectional study Setting: King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from January 2008 to December 2010. Subjects: Two hundred patients with RA Intervention(s): None Main Outcome Measure(s): Depression was evaluated using the Beck Depression Inventory, and disease activity was evaluated using the 28-Joint Disease Activity Score index. Risk factors that may predispose to depression have been evaluated. Results: The prevalence of depression in RA patients was 18%. Depression was more common in RA patients with high disease activity (56%) than in those with low disease activity (5%). There was a significant correlation between depression and RA disease activity (r = 0.366, p = 0.001). Patients with high disease activity had twice the risk of developing depression relative to patients with low disease activity (OR = 2.41 [95% CI 1.09-5.34]). Whenever a physician found a state of high disease activity in a patient, depression could be predicted to occur 73% of the time. Conclusion: Depression could be expected among RA patients with high disease activity. Rheumatologists should consider assessing the psychological status of their patients, especially those with high disease activity, to optimize medical treatment and to ensure adherence to medication.