New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis - Implications from the prospective multicenter VADERA II study

Englbrecht M, Alten R, Aringer M, Baerwald CG, Burkharde H, Eby N, Flacke JP, Fliedner G, Henkemeier U, Hofmann MW, Kleinert S, Kneitz C, Krueger K, Pohl C, Schett G, Schmalzing M, Tausche AK, Tony HP, Wendler J (2019)

Publication Type: Journal article

Publication year: 2019

Journal

PLoS ONE Public Library of Science

Book Volume: 14

Article Number: e0217412

Journal Issue: 5

DOI: 10.1371/journal.pone.0217412

Abstract

Objectives To investigate the prevalence of depressive symptoms in rheumatoid arthritis (RA) patients using two previously validated questionnaires in a large patient sample, and to evaluate depressive symptoms in the context of clinical characteristics (e.g. remission of disease) and patient-reported impact of disease. Methods In this cross-sectional study, the previously validated Patient Health Questionnaire (PHQ-9) and Beck-Depression Inventory II (BDI-II) were used to assess the extent of depressive symptoms in RA patients. Demographic background, RA disease activity score (DAS28), RA impact of disease (RAID) score, comorbidities, anti-rheumatic therapy and antidepressive treatment, were recorded. Cut-off values for depressive symptomatology were PHQ-9 ≥5 or BDI-II ≥14 for mild depressive symptoms or worse and PHQ-9 ≥ 10 or BDI-II ≥ 20 for moderate depressive symptoms or worse. Prevalence of depressive symptomatology was derived by frequency analysis while factors independently associated with depressive symptomatology were investigated by using multiple logistic regression analyses. Ethics committee approval was obtained, and all patients provided written informed consent before participation. Results In 1004 RA-patients (75.1% female, mean±SD age: 61.0±12.9 years, mean disease duration: 12.2±9.9 years, DAS28 (ESR): 2.5±1.2), the prevalence of depressive symptoms was 55.4% (mild or worse) and 22.8% (moderate or worse). Characteristics independently associated with depressive symptomatology were: age <60 years (OR = 1.78), RAID score >2 (OR = 10.54) and presence of chronic pain (OR = 3.25). Of patients classified as having depressive symptoms, only 11.7% were receiving anti-depressive therapy. Conclusions Mild and moderate depressive symptoms were common in RA patients according to validated tools. In routine clinical practice, screening for depression with corresponding followup procedures is as relevant as incorporating these results with patient-reported outcomes (e.g. symptom state), because the mere assessment of clinical disease activity does not sufficiently reflect the prevalence of depressive symptoms.

Authors with CRIS profile

Matthias Englbrecht Lehrstuhl für Innere Medizin III Georg Schett Lehrstuhl für Innere Medizin III

Involved external institutions

Universitätsklinikum Würzburg DE Germany (DE) Technische Universität Dresden DE Germany (DE) Charité - Universitätsmedizin Berlin DE Germany (DE) Roche Deutschland Holding GmbH DE Germany (DE) AMS Advanced Medical Services GmbH DE Germany (DE) Universitätsklinikum Frankfurt am Main (KGU) DE Germany (DE) Klinikum Südstadt Rostock DE Germany (DE) Praxiszentrum St. Bonifatius DE Germany (DE) Chugai Pharma Europe Ltd GB United Kingdom (GB) Universitätsklinikum Leipzig DE Germany (DE)

How to cite

APA:

Englbrecht, M., Alten, R., Aringer, M., Baerwald, C.G., Burkharde, H., Eby, N.,... Wendler, J. (2019). New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis - Implications from the prospective multicenter VADERA II study. PLoS ONE, 14(5). https://dx.doi.org/10.1371/journal.pone.0217412

MLA:

Englbrecht, Matthias, et al. "New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis - Implications from the prospective multicenter VADERA II study." PLoS ONE 14.5 (2019).

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