1
|
Chen Y, Guo H, Li Z, Huang L, Hong T, Wang H. Association of self-reported arthritis with depression, anxiety, and comorbid depression/anxiety among the older Chinese adults: A cross-sectional study. J Affect Disord 2024; 354:323-330. [PMID: 38494138 DOI: 10.1016/j.jad.2024.03.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/19/2024] [Accepted: 03/14/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Arthritis is relatively common among middle-aged and older people and is a significant public health problem. However, research on the relationship between arthritis and mental health in older populations is currently limited. METHODS Data were obtained from the Chinese Longitudinal Healthy Longevity Survey. The 10-item Center for Epidemiologic Studies Depression Scale and 7-item Generalized Anxiety Disorder Scale were used to evaluate depressive and anxiety symptoms. Arthritis status was self-reported. Linear and logistic regression analyses were conducted to assess the impact of arthritis on depression, anxiety, and comorbid depression/anxiety symptoms. RESULTS A total of 11,104 participants aged ≥65 years (mean age, 83.1 ± 11.1 years) were included in the analysis. We detected positive associations of arthritis with depression symptoms (adjusted odds ratio [OR]: 1.57, 95 % confidence interval [CI] 1.33 to 1.86), anxiety symptoms (adjusted OR: 1.48, 95 % CI: 1.15 to 1.90), and comorbid depression/anxiety symptoms (adjusted OR: 1.88, 95 % CI: 1.41 to 2.5) in the older adult population. Participants with arthritis had higher anxiety (adjusted linear regression coefficient: 0.43, 95 % CI: 0.24 to 0.63) and depression (adjusted linear regression coefficient: 0.87, 95 % CI: 0.57 to 1.14) scores compared with those without arthritis. In addition, there were no significant interaction effects between arthritis and participant characteristics on depression symptoms, anxiety symptoms, or comorbid depression/anxiety symptoms. CONCLUSIONS Arthritis was positively associated with depression symptoms, anxiety symptoms, and comorbid depression/anxiety symptoms among older adults. Further cohort studies are needed to validate these associations.
Collapse
Affiliation(s)
- Yu Chen
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang 110122, China.
| | - Huifang Guo
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Zheng Li
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Lina Huang
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Tao Hong
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Haiyuan Wang
- Department of Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China.
| |
Collapse
|
2
|
Ionescu CE, Popescu CC, Agache M, Dinache G, Codreanu C. Depression in Rheumatoid Arthritis: Prevalence and Effects on Disease Activity. J Clin Med 2024; 13:2058. [PMID: 38610822 PMCID: PMC11012436 DOI: 10.3390/jcm13072058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/21/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Background:The primary objective of this study was to estimate depression's prevalence in a cohort of rheumatoid arthritis (RA) patients, and the secondary objective was to evaluate the impact of depression on disease activity over time. Methods: We included all patients with RA presenting to our clinic from 2019 to 2020, who had three follow-up visits available. Depression prevalence was calculated using the patient's history of diagnosed depression, and disease activity was assessed using the disease activity score for 28 joints (DAS28) and its components: tender joint count (TJC), swollen joint count (SJC), pain value on a visual analog scale (VAS), and inflammatory markers. Results: A total of 400 RA patients were included, 75 of whom had diagnosed depression, generating a prevalence of 18.8%. The mean values of DAS28 and its components were higher, with statistical significance, in the depression subgroup at all three follow-ups (p < 0.001). Conclusions: Depression is prevalent in the RA population, and leads to higher disease activity in dynamic evaluations. Assessing depression could be a psychological marker for RA prognosis with an important outcome in controlling disease activity.
Collapse
Affiliation(s)
- Cătălina-Elena Ionescu
- Rheumatology Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-E.I.); (M.A.); (G.D.); (C.C.)
- “Dr. Ion Stoia” Clinical Center of Rheumatic Diseases, 030167 Bucharest, Romania
| | - Claudiu Costinel Popescu
- Rheumatology Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-E.I.); (M.A.); (G.D.); (C.C.)
- “Dr. Ion Stoia” Clinical Center of Rheumatic Diseases, 030167 Bucharest, Romania
| | - Mihaela Agache
- Rheumatology Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-E.I.); (M.A.); (G.D.); (C.C.)
- “Dr. Ion Stoia” Clinical Center of Rheumatic Diseases, 030167 Bucharest, Romania
| | - Georgiana Dinache
- Rheumatology Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-E.I.); (M.A.); (G.D.); (C.C.)
- “Dr. Ion Stoia” Clinical Center of Rheumatic Diseases, 030167 Bucharest, Romania
| | - Cătălin Codreanu
- Rheumatology Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-E.I.); (M.A.); (G.D.); (C.C.)
- “Dr. Ion Stoia” Clinical Center of Rheumatic Diseases, 030167 Bucharest, Romania
| |
Collapse
|
3
|
Jeon KH, Han K, Jung J, Park CI, Eun Y, Shin DW, Kim H. Rheumatoid Arthritis and Risk of Depression in South Korea. JAMA Netw Open 2024; 7:e241139. [PMID: 38441894 PMCID: PMC10915683 DOI: 10.1001/jamanetworkopen.2024.1139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/13/2024] [Indexed: 03/07/2024] Open
Abstract
Importance Depression is among the most common comorbidities in rheumatoid arthritis (RA). There is a lack of data regarding the association of RA seropositivity and biologic agents with depression risk among individuals with RA. Objective To investigate the risk of depression following RA diagnosis among patients in South Korea. Design, Setting, and Participants This retrospective cohort study included 38 487 patients with RA and a comparison group of 192 435 individuals matched 1:5 for age, sex, and index date. Data were from the Korean National Health Insurance Service database. Participants were enrolled from 2010 to 2017 and were followed up until 2019. Participants who had previously been diagnosed with depression or were diagnosed with depression within 1 year after the index date were excluded. Statistical analysis was performed in May 2023. Exposures Seropositive RA (SPRA) was defined with the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes M05 and enrollment in the Korean Rare and Intractable Diseases program. Seronegative RA (SNRA) was defined with ICD-10 codes M06 (excluding M06.1 and M06.4) and a prescription of any disease-modifying antirheumatic drugs (DMARDs) for 270 days or more. Main Outcomes and Measures Newly diagnosed depression (ICD-10 codes F32 or F33). Results The mean (SD) age of the total study population was 54.6 (12.1) years, and 163 926 individuals (71.0%) were female. During a median (IQR) follow-up of 4.1 (2.4-6.2) years, 27 063 participants (20 641 controls and 6422 with RA) developed depression. Participants with RA had a 1.66-fold higher risk of depression compared with controls (adjusted hazard ratio [aHR], 1.66 [95% CI, 1.61-1.71]). The SPRA group (aHR, 1.64 [95% CI, 1.58-1.69]) and the SNRA group (aHR, 1.73 [95% CI, 1.65-1.81]) were associated with an increased risk of depression compared with controls. Patients with RA who used biologic or targeted synthetic DMARDs (aHR, 1.33 [95% CI, 1.20-1.47]) had a lower risk of depression compared with patients with RA who did not use these medications (aHR, 1.69 [95% CI, 1.64-1.74]). Conclusions and Relevance This nationwide cohort study found that both SPRA and SNRA were associated with a significantly higher risk of depression. These results suggest the importance of early screening and intervention for mental health in patients with RA.
Collapse
Affiliation(s)
- Keun Hye Jeon
- Department of Family Medicine, CHA Gumi Medical Center, CHA University School of Medicine, Gumi, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Jinhyoung Jung
- Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Chun Il Park
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Yeonghee Eun
- Division of Rheumatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hyungjin Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Medical Humanities, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| |
Collapse
|
4
|
Dmitrzak-Węglarz M, Rybakowski J, Szczepankiewicz A, Kapelski P, Lesicka M, Jabłońska E, Reszka E, Pawlak J. Identification of shared disease marker genes and underlying mechanisms between major depression and rheumatoid arthritis. J Psychiatr Res 2023; 168:22-29. [PMID: 37871462 DOI: 10.1016/j.jpsychires.2023.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/28/2023] [Accepted: 10/16/2023] [Indexed: 10/25/2023]
Abstract
Both depression and rheumatoid arthritis (RA) have a very high comorbidity rate. A bilateral association is estimated to increase the mutual risk and the common denominator is inflammation being observed in both diseases. Previous studies have mainly focused on assessing peripheral blood's inflammatory and pro-inflammatory cytokines levels. We aimed to extend insights into the molecular mechanisms of depression based on hub RA genes. To do so, we prioritized RA-related genes using in-silico tools. We then investigated whether RA-related genes undergo altered expression in patients with unipolar and bipolar depression without a concurrent RA diagnosis and any exponents of active inflammation. In addition, we selected a homogeneous group of patients treated with lithium (Li), which has immunomodulatory properties. The study was performed on patients with bipolar depression (BD, n = 45; Li, n = 20), unipolar depression (UD, n = 27), and healthy controls (HC, n = 22) of both sexes. To identify DEGs in peripheral blood mononuclear cells (PBMCs), we used the SurePrint G3 Microarray and GeneSpring software. We selected a list of 180 hub genes whose altered expression we analyzed using the expression microarray results. In the entire study group, we identified altered expression of 93 of the 180 genes, including 35 down-regulated (OPRM1 gene with highest FC > 3) and 58 up-regulated (TLR4 gene with highest FC > 3). In UD patients, we observed maximally up-regulated expression of the TEK gene (FC > 3), and in BD of the CXCL8 gene (FC > 5). On the other hand, in lithium-treated patients, the gene with the most reduced expression was the TRPV1 gene. The study proved that depression and RA are produced by a partially shared "inflammatory interactome" in which the opioid and angiogenesis pathways are important.
Collapse
Affiliation(s)
| | - Janusz Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poland.
| | - Aleksandra Szczepankiewicz
- Laboratory of Molecular and Cell Biology, Department of Pediatric Pulmonology, Allergy and Clinical Immunology, Poznan University of Medical Sciences, Poland.
| | - Paweł Kapelski
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poland.
| | - Monika Lesicka
- Department of Translational Research, Nofer Institute of Occupational Medicine, Lodz, Poland.
| | - Ewa Jabłońska
- Department of Translational Research, Nofer Institute of Occupational Medicine, Lodz, Poland.
| | - Edyta Reszka
- Department of Translational Research, Nofer Institute of Occupational Medicine, Lodz, Poland.
| | - Joanna Pawlak
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poland.
| |
Collapse
|
5
|
Mudra Rakshasa-Loots A. Depression and HIV: a scoping review in search of neuroimmune biomarkers. Brain Commun 2023; 5:fcad231. [PMID: 37693812 PMCID: PMC10489482 DOI: 10.1093/braincomms/fcad231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 07/13/2023] [Accepted: 08/23/2023] [Indexed: 09/12/2023] Open
Abstract
People with HIV are at increased risk for depression, though the neurobiological mechanisms underlying this are unclear. In the last decade, there has been a substantial rise in interest in the contribution of (neuro)inflammation to depression, coupled with rapid advancements in the resolution and sensitivity of biomarker assays such as Luminex, single molecular array and newly developed positron emission tomography radioligands. Numerous pre-clinical and clinical studies have recently leveraged these next-generation immunoassays to identify biomarkers that may be associated with HIV and depression (separately), though few studies have explored these biomarkers in co-occurring HIV and depression. Using a systematic search, we detected 33 publications involving a cumulative N = 10 590 participants which tested for associations between depressive symptoms and 55 biomarkers of inflammation and related processes in participants living with HIV. Formal meta-analyses were not possible as statistical reporting in the field was highly variable; future studies must fully report test statistics and effect size estimates. The majority of included studies were carried out in the United States, with samples that were primarily older and primarily men. Substantial further work is necessary to diversify the geographical, age, and sex distribution of samples in the field. This review finds that alterations in concentrations of certain biomarkers of neuroinflammation (interleukin-6, tumour necrosis factor-α, neopterin) may influence the association between HIV and depression. Equally, the chemokines monocyte chemoattractant protein-1 (MCP-1) and interleukin-8 (IL-8) or the metabolic index kynurenine:tryptophan (Kyn:Trp), which have been the focus of several studies, do not appear to be associated with depressive symptoms amongst people living with HIV, as all (MCP-1) or most (IL-8 and Kyn:Trp) available studies of these biomarkers reported non-significant associations. We propose a biomarker-driven hypothesis of the neuroimmunometabolic mechanisms that may precipitate the increased risk of depression among people with HIV. Chronically activated microglia, which trigger key neuroinflammatory cascades shown to be upregulated in people with HIV, may be the central link connecting HIV infection in the central nervous system with depressive symptoms. Findings from this review may inform research design in future studies of HIV-associated depression and enable concerted efforts towards biomarker discovery.
Collapse
Affiliation(s)
- Arish Mudra Rakshasa-Loots
- Edinburgh Neuroscience, School of Biomedical Sciences, The University of Edinburgh, Edinburgh EH8 9JZ, UK
- Family Centre for Research with Ubuntu (FAMCRU), Tygerberg Hospital, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town 7505, South Africa
- Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton BN2 5BE, UK
| |
Collapse
|
6
|
Ren H, Lin F, Wu L, Tan L, Lu L, Xie X, Zhang Y, Bao Y, Ma Y, Huang X, Wang F, Jin Y. The prevalence and the effect of interferon -γ in the comorbidity of rheumatoid arthritis and depression. Behav Brain Res 2023; 439:114237. [PMID: 36464027 DOI: 10.1016/j.bbr.2022.114237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/17/2022] [Accepted: 11/26/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Depression is the most common comorbidities associated with rheumatoid arthritis (RA). We aimed to explore the mechanism of association between RA and depression. METHODS 120 subjects were enrolled and depression was diagnosed and assessed using DSM-5 and 24-item version of Hamilton Depression Scale. Pain intensity and joint function in patients with RA were assessed using the visual analog scale (VAS) and health assessment questionnaire (HAQ). Serum levels of interferon-gamma (IFN-γ), indoleamine 2,3-dioxygenase (IDO), kynurenine (KYN), tryptophan (TRP), and quinolinic acid (QUIN)were detected. In animal experiments, K/BxN mice with RA-like phenotype was used and depressive behavior was observed. The protein expression level of N-methyl -D- aspartate receptor 2B (NR2B) in the hippocampus was detected. RESULTS In this study, 36.67 % of patients with RA also had depression. The working status, month family income, tender joint count, the VAS and HAQ score were the main factors influencing the depression in RA patients. HAQ score was found to be an independent risk factor for depression in RA. Serum IDO, IFN-γ, KYN were increased and TRP contents were decreased in RA group. K/BxN mice with RA-like phenotype showed depressive behavior. However, injection of IFN-γ neutralizing antibody could inhibit kynurenine pathway and reverse the depressive behavior in mice. The levels of QUIN in the neurotoxic metabolic pathway were increased and N-methyl -D- aspartate receptors (NMDAR) were activated, which may be the mechanism behind the onset of depression. CONCLUSIONS From clinical and preclinical aspects, the occurrence of depression in RA was explored and the related mechanism was revealed.
Collapse
Affiliation(s)
- Huan Ren
- Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Medical University, Hefei, Anhui, China; The Key Laboratory of Anti-inflammatory and Immune medicines, Ministry of Education, Hefei, China.
| | - Fengmei Lin
- Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Medical University, Hefei, Anhui, China; Pharmacy Department, The First People's Hospital of ChuZhou, China.
| | - Lifang Wu
- Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Medical University, Hefei, Anhui, China; The Key Laboratory of Anti-inflammatory and Immune medicines, Ministry of Education, Hefei, China
| | - Lina Tan
- Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Medical University, Hefei, Anhui, China; The Key Laboratory of Anti-inflammatory and Immune medicines, Ministry of Education, Hefei, China
| | - Lili Lu
- Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Medical University, Hefei, Anhui, China; The Key Laboratory of Anti-inflammatory and Immune medicines, Ministry of Education, Hefei, China
| | - Xiuli Xie
- Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Medical University, Hefei, Anhui, China; The Key Laboratory of Anti-inflammatory and Immune medicines, Ministry of Education, Hefei, China
| | - Yang Zhang
- Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Medical University, Hefei, Anhui, China; The Key Laboratory of Anti-inflammatory and Immune medicines, Ministry of Education, Hefei, China
| | - Yanni Bao
- Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Medical University, Hefei, Anhui, China; The Key Laboratory of Anti-inflammatory and Immune medicines, Ministry of Education, Hefei, China
| | - Yuchen Ma
- Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Medical University, Hefei, Anhui, China; The Key Laboratory of Anti-inflammatory and Immune medicines, Ministry of Education, Hefei, China
| | - Xiaoqin Huang
- Department of Psychology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Fang Wang
- Department of Psychology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yong Jin
- Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, School of Pharmacy, Anhui Medical University, Hefei, Anhui, China; The Key Laboratory of Anti-inflammatory and Immune medicines, Ministry of Education, Hefei, China.
| |
Collapse
|
7
|
Liu N, Yan W, Su R, Zhang L, Wang X, Li Z, Qin D, Peng J. Research progress on rheumatoid arthritis-associated depression. Front Behav Neurosci 2023; 16:992223. [PMID: 36755665 PMCID: PMC9899853 DOI: 10.3389/fnbeh.2022.992223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/30/2022] [Indexed: 01/24/2023] Open
Abstract
Depression is an independent mood disorder and one of the most common comorbidities of rheumatoid arthritis (RA). Growing evidence suggests that there is two-way regulation between RA and depression, resulting in a vicious cycle of RA, depression, poor outcomes, and disease burden. The rising prevalence of RA-associated depression warrants a re-examination of the relationships between them. Here we provide an overview of the etiology and pathological mechanisms of RA-associated depression, and recent advances in treatment with biologics, which will facilitate the development of new and effective prevention and treatment strategies.
Collapse
Affiliation(s)
- Nian Liu
- First Clinical Medical School, Yunnan University of Chinese Medicine, Kunming, China
| | - Weitian Yan
- First Clinical Medical School, Yunnan University of Chinese Medicine, Kunming, China
| | - Rong Su
- Rheumatism Center, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Lin Zhang
- First Clinical Medical School, Yunnan University of Chinese Medicine, Kunming, China
| | - Xingqiang Wang
- Rheumatism Center, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Zhaofu Li
- Basic Medical School, Yunnan University of Chinese Medicine, Kunming, China,*Correspondence: Zhaofu Li Dongdong Qin Jiangyun Peng
| | - Dongdong Qin
- Basic Medical School, Yunnan University of Chinese Medicine, Kunming, China,*Correspondence: Zhaofu Li Dongdong Qin Jiangyun Peng
| | - Jiangyun Peng
- Rheumatism Center, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China,*Correspondence: Zhaofu Li Dongdong Qin Jiangyun Peng
| |
Collapse
|
8
|
Screening for depressive symptoms in patients with rheumatoid arthritis: relationship with pain severity, disease activity, and sleep quality. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00239-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Rheumatoid arthritis (RA) is an autoimmune systemic condition that primarily affects all synovial joints, eventually leading to deformity and clinical disability. Much progress has been made in the evaluation of inflammation and disease activity in recent years; however, other factors that can influence these patients’ quality of life, including depression, stress, fatigue, sleep problems, fibromyalgia, sexual activity, and obesity, are often not evaluated by rheumatologists. Our purpose was to explore depressive symptoms in patients with RA and determine how they connected to other aspects of the disease, including pain severity, disease activity, and sleep quality.
Results
A cross-sectional study including 1200 patients with RA was performed. Paints with RA were classified into two groups based on the presence or absence of depressive symptoms using the Beck Depression Inventory-II (BDI-II). Group 1 included patients with both RA and depressive symptoms of varying severity; group 2 included patients with RA but without depressive symptoms. The patients underwent clinical evaluation and application of the Pittsburgh Sleep Quality Index (PSQI), Health Assessment Questionnaire for pain (HAQ-pain), and the Multidimensional Assessment of Fatigue scale (MAF). RA disease activity was evaluated using the DAS28 score. Depressive symptoms of varying severity were prevalent in 96% of our patients with RA, of whom 43.3% had minimal depression, while 13.7% had severe depression. The RA group with depression had a longer duration of disease, prolonged morning stiffness, and high disease activity measured by the DAS28 score than patients with only RA. In RA patients with concomitant depression, pain, sleep, and fatigue scores were also worse.
Conclusions
The presence of depression among patients with RA was associated with worse DAS28, HAQ, PASQI, and fatigue scores. Screening and recognition of such psychosocial disorders may help patients achieve optimal disease control and a good outcome.
Collapse
|
9
|
Majnik J, Császár-Nagy N, Böcskei G, Bender T, Nagy G. Non-pharmacological treatment in difficult-to-treat rheumatoid arthritis. Front Med (Lausanne) 2022; 9:991677. [PMID: 36106320 PMCID: PMC9465607 DOI: 10.3389/fmed.2022.991677] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022] Open
Abstract
Although the management of rheumatoid arthritis (RA) has improved remarkably with new pharmacological therapies, there is still a significant part of patients not reaching treatment goals. Difficult-to-treat RA (D2TRA) is a complex entity involving several factors apart from persistent inflammation, thereafter requiring a holistic management approach. As pharmacological treatment options are often limited in D2TRA, the need for non-pharmacological treatments (NPT) is even more pronounced. The mechanism of action of non-pharmacological treatments is not well investigated, NPTs seem to have a complex, holistic effect including the immune, neural and endocrine system, which can have a significant additive benefit together with targeted pharmacotherapies in the treatment of D2TRA. In this review we summarize the current knowledge on different NPT in rheumatoid arthritis, and we propose a NPT plan to follow when managing D2TRA patients.
Collapse
Affiliation(s)
- Judit Majnik
- Department of Rheumatology and Clinical Immunology, Semmelweis University, Budapest, Hungary
- Hospital of the Hospitaller Order of Saint John of God, Budapest, Hungary
- *Correspondence: Judit Majnik,
| | - Noémi Császár-Nagy
- Department of Public Management and Information Technology, Faculty of Science of Public Governance and Administration, National University of Public Service, Budapest, Hungary
| | - Georgina Böcskei
- Hospital of the Hospitaller Order of Saint John of God, Budapest, Hungary
| | - Tamás Bender
- Hospital of the Hospitaller Order of Saint John of God, Budapest, Hungary
| | - György Nagy
- Department of Rheumatology and Clinical Immunology, Semmelweis University, Budapest, Hungary
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- Department of Genetics, Cell- and Immunobiology, Semmelweis University, Budapest, Hungary
| |
Collapse
|
10
|
Ng CYH, Tay SH, McIntyre RS, Ho R, Tam WWS, Ho CSH. Elucidating a bidirectional association between rheumatoid arthritis and depression: A systematic review and meta-analysis. J Affect Disord 2022; 311:407-415. [PMID: 35642835 DOI: 10.1016/j.jad.2022.05.108] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Rheumatoid arthritis (RA) and depression are conditions which commonly co-exist. Recent longitudinal studies now suggest a bidirectional association between these disorders, with inconsistent results. We conducted a systematic review and meta-analysis to examine this relationship. METHODS Three electronic databases (PubMed, Embase and PsycINFO) were searched from inception to September 4, 2021 for cohort studies evaluating either the risk of depression in RA patients or the risk of RA in patients with depression, as well as the secondary outcome of all-cause mortality risk in RA patients with depression. A random effects model was used to summarize the included studies. RESULTS Eleven cohort studies were included, comprising a total of 39,130 RA patients, 550,782 patients with depression and 7,802,230 controls. RA patients had a 47% greater risk of incident depression compared to controls, while patients with depression had a 34% greater risk of developing RA. Subgroup analysis by age was only significant in the ≥60 years old age group. RA patients with depression had an 80% increased risk of all-cause mortality compared to those without depression. LIMITATIONS The results may have been confounded by factors such as differing methods of depression ascertainment across studies and overlap in presentation between the two conditions. CONCLUSION There exists a bidirectional association between RA and depression especially in the elderly which increases mortality risk. This invites the need for clinicians to screen and be vigilant for the presence of these conditions.
Collapse
Affiliation(s)
- Chester Yan Hao Ng
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sen Hee Tay
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Rheumatology, University Medicine Cluster, National University Health System, Singapore
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Roger Ho
- Department of Psychological Medicine, National University Hospital, Singapore; Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore.
| | - Wilson W S Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Hospital, Singapore; Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| |
Collapse
|
11
|
Hyun S, Lee Y, Park S. No travel worsens depression: reciprocal relationship between travel and depression among older adults. Ann Gen Psychiatry 2022; 21:31. [PMID: 35948992 PMCID: PMC9364576 DOI: 10.1186/s12991-022-00405-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/13/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The aim of this study was to examine the bidirectional relationship between depression and travel. METHOD We analyzed 8524 participants' data obtained from the 2008 to 2016 waves of the Korean Longitudinal Study of Ageing, a prospective cohort study. Depression was diagnosed using the Center for Epidemiological Studies Depression Scale: 10-Items (CES-D10), with scores of 4 or higher indicating depression. We used a generalized estimating equation and a cross-lagged panel model for statistical analysis. RESULTS Participants who had not traveled for one year had a 71% higher risk of suffering from depression in the following year than did those who had traveled [relative risk (RR) = 1.71, P < 0.001], and participants with depression had more than double the increased risk of not traveling than did those not currently suffering from depression (RR = 2.08, P < 0.001). The cross-lagged panel model confirmed the vicious cycle involving the amount of travel and score on the CES-D10; individuals who traveled more frequently were more likely to have lower scores on the CES-D10 (coefficient = - 0.04 to - 0.03, Ps < 0.01), and individuals with higher scores were less likely to travel (coefficient = - 0.06 to - 0.03, Ps < 0.01). CONCLUSIONS The risk of depression increases for people who do not travel, and a reciprocal relationship exists between travel and depression.
Collapse
Affiliation(s)
- Seungjae Hyun
- Graduate School of Urban Public Health & Department of Urban Big Data Convergence, University of Seoul, Seoul, Republic of Korea
| | - Yeonjin Lee
- Department of Sociology, Kookmin University, 77 Jeongreung-ro, Seongbuk-gu, Seoul, Republic of Korea.
| | - Sangshin Park
- Graduate School of Urban Public Health & Department of Urban Big Data Convergence, University of Seoul, Seoul, Republic of Korea
| |
Collapse
|
12
|
Population-based study for the comorbidities and associated factors in Ménière's disease. Sci Rep 2022; 12:8266. [PMID: 35585157 PMCID: PMC9117186 DOI: 10.1038/s41598-022-12492-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/06/2022] [Indexed: 11/09/2022] Open
Abstract
To date, no study has reported the objective metabolic laboratory findings worldwide or the comorbidities for Ménière’s disease (MD) using a population-based design in Asian populations. The aim of this study was to investigate the comorbidities and associated factors for MD using the Korean National Health Insurance Service database. This retrospective population-based study was conducted using a data from the National Sample Cohort database from 2009 to 2015. We only enrolled patients whose records showed a prescription for MD medicine and audiometry findings as well as an appropriate diagnostic code. We also included a matched cohort without MD who were enrolled randomly and matched for sex, age, year of diagnosis, income level, and residential area with the MD group with a ratio of 10:1. We evaluated comorbidities including autoimmune, allergic, metabolic diseases and cancer and the health screening data including general characteristics (height, weight, waist circumference, body mass index, and blood pressure), laboratory findings (fasting glucose, cholesterol, triglyceride, high-density lipoproteintryglyceride (HDL) cholesterol, low-density lipoproteintryglyceride cholesterol, hemoglobin, creatinine, aspartate aminotransferase and alanine aminotransferase, and gamma-glutamyltrans- peptidase (rGT)), and general health behaviors (smoking, alcohol, and exercise) of the MD group, and compared these characteristics with those of the MD-free control group. A total of 2,013 and 20,130 participants were included in the MD and MD-free control groups (1,640 and 15,458 for health screening data). We found the increase in incidence of allergic rhinitis and allergic asthma, decrease in systolic blood pressure, HDL cholesterol, and rGT, and less frequent alcohol consumption and less prevalent smoking in the MD group. No significant differences were observed between the groups in the incidence of autoimmune diseases, and cerebro- and cardiovascular disease as well as health screening data and objective laboratory findings. Inconsistence with published studies, the results of this study suggest that the autoimmunity and metabolic disorder, and skeletal growth might not be associated with the onset of MD. Another well-designed study for other races will be needed to the generalization of this study results.
Collapse
|
13
|
Calderón Espinoza I, Chavarria-Avila E, Pizano-Martinez O, Martínez-García EA, Armendariz-Borunda J, Marquez-Aguirre AL, Llamas-García A, Corona-Sánchez EG, Toriz González G, Vazquez-Del Mercado M. Suicide Risk in Rheumatoid Arthritis Patients is Associated With Suboptimal Vitamin D Levels. J Clin Rheumatol 2022; 28:137-142. [PMID: 35293886 PMCID: PMC8946603 DOI: 10.1097/rhu.0000000000001823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND/OBJECTIVE Rheumatoid arthritis (RA) patients might experience anxiety and depressive symptoms. Deficient vitamin D levels may be a trigger for these conditions. The aim of this study was to determine the frequency of depression, anxiety symptoms, and suicidal risk or ideation in patients with RA associated with vitamin D serum levels. METHODS In this cross-sectional study, we recruited RA patients older than 18 years, classified into 3 groups according to serum vitamin D levels: sufficient, ≥30 ng/mL; insufficient, 20-29 ng/mL; and deficient, <20 ng/mL. Based on the self-reported Plutchik and the Hospital Anxiety and Depression Scale, we evaluated the association of suicidal risk, depression, and anxiety with the vitamin D levels in RA and the Rheumatoid Arthritis Quality-of-Life Questionnaire. RESULTS We studied 72 patients with RA between January and October 2019. We found an inverse correlation between Plutchik score and suicidal risk with inadequate vitamin D levels, but not with the Hospital Anxiety and Depression Scale. Suicidal ideation was associated with a higher score on the Rheumatoid Arthritis Quality-of-Life Questionnaire. CONCLUSIONS Despite the high prevalence of depressive and anxiety symptoms in RA patients, a Plutchik low correlation coefficient with inadequate serum levels of vitamin D was found. However, in the analysis of covariance, we were able to find that vitamin D levels remain associated with a reduction of suicide ideation. Further studies are needed to identify a risk profile for early psychological interventions to improve the quality of life in RA patients.
Collapse
Affiliation(s)
- Ivette Calderón Espinoza
- From the Hospital Civil Dr. Juan I. Menchaca, División de Medicina Interna, Servicio de Reumatología 004086, PNPC CONACyT
| | - Efrain Chavarria-Avila
- From the Hospital Civil Dr. Juan I. Menchaca, División de Medicina Interna, Servicio de Reumatología 004086, PNPC CONACyT
- Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME)
- Departamento de Disciplinas Filosófico, Metodológicas e Instrumentales
| | - Oscar Pizano-Martinez
- From the Hospital Civil Dr. Juan I. Menchaca, División de Medicina Interna, Servicio de Reumatología 004086, PNPC CONACyT
- Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME)
- Departamento de Morfología
- UDG-CA-703, Inmunología y Reumatología
| | - Erika Aurora Martínez-García
- Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME)
- UDG-CA-703, Inmunología y Reumatología
- Departamento de Fisiología
| | - Juan Armendariz-Borunda
- Instituto de Biología Molecular en Medicina, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Guadalajara
- Tecnológico de Monterrey Campus Guadalajara, Zapopan
| | - Ana Laura Marquez-Aguirre
- Unidad de Biotecnología Médica y Farmacéutica, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco (CIATEJ), A.C., Guadalajara
| | - Arcelia Llamas-García
- From the Hospital Civil Dr. Juan I. Menchaca, División de Medicina Interna, Servicio de Reumatología 004086, PNPC CONACyT
| | - Esther Guadalupe Corona-Sánchez
- Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME)
- UDG-CA-703, Inmunología y Reumatología
- Departamento de Fisiología
| | | | - Monica Vazquez-Del Mercado
- From the Hospital Civil Dr. Juan I. Menchaca, División de Medicina Interna, Servicio de Reumatología 004086, PNPC CONACyT
- Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME)
- UDG-CA-703, Inmunología y Reumatología
| |
Collapse
|
14
|
Jeong SH, Kim SH, Park M, Kwon J, Lee HJ, Park EC. Arthritis status changes and depressive symptoms among middle-aged and older Koreans: Analysis of data from the Korean Longitudinal Study of Aging survey. J Psychosom Res 2021; 151:110662. [PMID: 34739945 DOI: 10.1016/j.jpsychores.2021.110662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/27/2021] [Accepted: 10/27/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Arthritis can negatively affect physical and mental health, especially among middle-aged and older people. This study investigated the longitudinal association between changes in arthritis status and depressive symptoms among Korean adults aged ≥45 years. METHODS We analyzed data from the Korean Longitudinal Study of Aging 2008-2018, using a generalized estimating equation model to investigate associations between arthritis status change and depressive symptoms, which were assessed using five categories according to measurements based on the Center for Epidemiological Studies Depression Scale (CES-D-10). RESULTS Both men and women whose arthritis status changed to "worse" or remained "same" scored higher for depressive symptoms than those who reported "no symptoms of arthritis" (men, worse = β: 1.07, P ≤ .001, same = β: 0.25 P = .031; women, worse = β: 0.99, P ≤ .001, same = β: 0.13, P = .049). Conversely, men with a "better" arthritis status (β: -0.71, P ≤ .001) and women with a "recovered" arthritis status (β: -0.56, P = .031) scored lower for depressive symptoms than those who reported "no symptoms of arthritis." CONCLUSIONS Arthritis status changes are associated with depressive symptoms in middle-aged and older Koreans. Therefore, mental health evaluation and management interventions are recommended for patients with arthritis and changes in disease status.
Collapse
Affiliation(s)
- Sung Hoon Jeong
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Seung Hoon Kim
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minah Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Junhyun Kwon
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Hyeon Ji Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
15
|
Ke C, Qiao Y, Liu S, Rui Y, Wu Y. Longitudinal research on the bidirectional association between depression and arthritis. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1241-1247. [PMID: 33221928 DOI: 10.1007/s00127-020-01994-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 11/10/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Studies evaluating the mutual relation between depression and arthritis have been limited and yielded inconsistent results. The aim of this study was to investigate the bidirectional relationship between depression and arthritis in a middle-aged and elderly Chinese population. METHODS Participants ≥ 45 years of age were included from the China Health and Retirement Longitudinal Study (CHARLS). In stage I, we assessed the association of baseline depression with follow-up arthritis. In stage II, we examined whether the onset of arthritis predicted future depression. Logistic regression analyses were conducted to estimate the odds ratios (ORs) and confidence intervals (CIs) in stage I and stage II, respectively. RESULTS In stage I, 24.3% (679/2794) of the depression group and 15.4% (1000/6482) of the non-depression group developed new arthritis cases. Compared with non-depression individuals, the risk of developing arthritis in depression patients was significantly higher (OR: 1.56, 95% CI 1.37-1.79). In stage II, 39.7% (973/2453) subjects in the arthritis group and 26.7% (1667/6236) subjects in the non-arthritis group developed depressive symptoms. The adjusted OR (95% CI) for depression in the arthritis group was 1.64 (1.45-1.86) times higher than that in the non-arthritis group. In the subgroup analyses according to sex, age, household income, residence, body mass index, smoking and drinking, all sub-groups yielded consistent associations. CONCLUSION The onset of depression increased the risk of incident arthritis; in addition, baseline arthritis predicted future depression in middle-aged and elderly Chinese adults.
Collapse
Affiliation(s)
- Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Yanan Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Siyuan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Yuqi Rui
- School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Ying Wu
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, People's Republic of China.
| |
Collapse
|
16
|
Kim YH, Lee JW, Kim Y, Bae JS, Kim YJ, Min C, Choi HG. Bidirectional association between migraine and rheumatoid arthritis: two longitudinal follow-up studies with a national sample cohort. BMJ Open 2021; 11:e046283. [PMID: 34103319 PMCID: PMC8190043 DOI: 10.1136/bmjopen-2020-046283] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To investigate the bidirectional association between migraine and rheumatoid arthritis (RA). DESIGN Two longitudinal follow-up studies. SETTING Data collected from a national cohort between 2002 and 2013 by the Korean National Health Insurance Service-Health Screening Cohort. PARTICIPANTS In cohort 1, matching resulted in the inclusion of 31 589 migraine patients and 126 356 control I participants. In cohort 2, matching resulted in the inclusion of 9287 RA patients and 37 148 control II participants. PRIMARY AND SECONDARY OUTCOME MEASURES The HRs for RA in patients with migraine (cohort 1) and migraine in patients with RA (cohort 2) were analysed using stratified Cox proportional hazard models after adjusting for autoimmune disease, Charlson Comorbidity Index scores without rheumatoid diseases, obesity (body mass index), smoking and history of alcohol intake. Subgroup analyses stratified by age, sex, income and region of residence were also performed. RESULTS The incidence of RA in the migraine group (2.0% (640/31 589)) was higher than that in the control I group (1.4% (1709/126 356), p<0.001). The adjusted HR for RA in the migraine without aura group was 1.48 (95% CIs=1.34 to 1.63, p<0.001).The incidence of migraine in the RA group (6.4% (590/9287)) was higher than that in the control II group (4.6% (1721/37 148), p<0.001). The adjusted HR for migraine without aura in the RA group was 1.35 (95% CI=1.23 to 1.49, p<0.001). CONCLUSION Migraine increases the risk of RA, and RA is also associated with an increased risk of migraine.
Collapse
Affiliation(s)
- Yoo Hwan Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, The Republic of Korea
| | - Jung Woo Lee
- Department of Orthopedic Surgery, Yonsei University Wonju College of Medicine, Wonju, The Republic of Korea
| | - Yerim Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, Seoul, The Republic of Korea
| | - Jong Seok Bae
- Department of Neurology, Kangdong Sacred Heart Hospital, Seoul, The Republic of Korea
| | - Yeo Jin Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Chuncheon, The Republic of Korea
| | - Chanyang Min
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, The Republic of Korea
- Graduate School of Public Health, Seoul National University, Seoul, The Republic of Korea
| | - Hyo Geun Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, The Republic of Korea
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, The Republic of Korea
| |
Collapse
|
17
|
Abstract
Chronic diseases commonly entail disability and are highly comorbid with mental health problems, particularly depression. Prevalence of depression across different disabling conditions affecting adult patients, as well as risk factors for depression in these patient groups are reviewed in the current work, with a particular focus on the literature published in the past 5 years. The prevalence of depression in disabling conditions is higher than in the general population and is associated with different factors. Examples of disease-specific factors include neurological implications of stoke, diabetic related conditions (e.g. amputation), limitations imposed by vision loss caused by age-related eye diseases, fatigue in rheumatoid arthritis, and pain in cancer. Common factors identified across different conditions include pre-morbid depression, history of mental health problems, poor social support, disease-related disability, multi-morbidity, and less adaptive coping strategies. We also reviewed studies suggesting a potential bidirectional relationship between depression and chronic disease, particularly for stroke, cardiovascular disease, diabetes, and potential factors mediating that relationship. Current findings suggested that long-term depression might be associated with an increased risk of subsequent physical health problems, although the nature of that relationship and its underlying mechanisms are still unclear.
Collapse
Affiliation(s)
- Hugo Senra
- Centre for Research in Neuropsychology and Cognitive and Behavioural Intervention (CINEICC), University of Coimbra, Coimbra, Portugal.,School of Health and Social Care, University of Essex, Colchester, UK
| | - Susan McPherson
- School of Health and Social Care, University of Essex, Colchester, UK
| |
Collapse
|
18
|
Melton PA, Sims OT, Oh H, Truong DN, Atim K, Simon C. African American Ethnicity, Hypertension, Diabetes, and Arthritis Independently Predict Co-occurring Depression and Obesity among Community-dwelling Older Adult Alabamians. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:344-353. [PMID: 33685384 DOI: 10.1080/19371918.2021.1895019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Although obesity and depression are quite common among older adults, surprisingly published literature has not examined factors associated with co-occurring depression and obesity among older adults. The knowledge that fills this gap would be advantageous for public health social workers and other health professionals who provide health care and public health services to older adults. The objectives of this study were to access the prevalence of and independent predictors of co-occurring depression and obesity among older adults in the state of Alabama. A retrospective analysis was conducted using a statewide survey of Alabamian community-dwelling older adults (n = 1,166). Binomial logistic regression was used to examine predictors of co-occurring depression and obesity. The prevalence of co-occurring depression and obesity among older adults was 16%. In the multivariate analysis, African American ethnicity (OR = 1.505, CI: 1.019-2.223), hypertension (OR = 1.593, CI: 1.050-2.416), diabetes (OR = 1.768, CI: 1.188-2.632), and arthritis (OR = 1.640, CI: 1.096-2.454) were positively associated with co-occurring depression and obesity). Older age (OR = 0.963, CI: 0.942-0.985) and higher levels of physical activity (OR = 1.640, CI: 1.096-2.454) were negatively associated with co-occurring depression and obesity. There is a need for the development and implementation of suitable interventions to prevent and manage co-occurring depression and obesity among older adults, particularly older adults with arthritis, hypertension, diabetes, or of African American ethnicity.
Collapse
Affiliation(s)
- Pamela A Melton
- School of Social Work, Tulane University, New Orleans, Louisiana, USA
| | - Omar T Sims
- Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Integrative Center for Healthy Aging, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for AIDS Research, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Hyejung Oh
- Department of Social Work, School of Social Sciences & Education, California State University Bakersfield, Bakersfield, California, USA
| | - Duong N Truong
- Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Collat School of Business, University of Alabama at Birmingham, Alabama, USA
| | - Kasey Atim
- Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Cassandra Simon
- School of Social Work, University of Alabama, Tuscaloosa, Alabama, USA
| |
Collapse
|
19
|
Espinoza G, Maldonado G, Narvaez J, Guerrero R, Citera G, Rios C. Beyond Rheumatoid Arthritis Evaluation: What are We Missing? Open Access Rheumatol 2021; 13:45-55. [PMID: 33790666 PMCID: PMC8007602 DOI: 10.2147/oarrr.s298393] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/05/2021] [Indexed: 12/30/2022] Open
Abstract
Rheumatoid Arthritis (RA) is a chronic inflammatory autoimmune systemic disease that preferentially affects small and large joints with a progressive course and can become deforming and disabling. In recent years, much progress has been made in the evaluation of inflammation and disease activity, however, there are other factors that have a high impact on the quality of life of these patients, such as depression, anxiety, fatigue, sleep disorders, suicidal behavior, fibromyalgia, sexual activity, sarcopenia, frailty, cachexia and obesity that are not always evaluated by rheumatologists. This review shows that the evaluation and timely detection of these aspects in patients with RA could interfere with the prognosis and improve their quality of life.
Collapse
Affiliation(s)
- Gianna Espinoza
- Rheumatology Department - Universidad Espiritu Santo, Samborondon, Ecuador
| | - Genessis Maldonado
- Internal Medicine Department - Loyola MacNeal Hospital, Berwyn, United States of America
| | - Jemina Narvaez
- Rheumatology Department - Universidad Espiritu Santo, Samborondon, Ecuador
| | - Roberto Guerrero
- Rheumatology Department - Universidad Espiritu Santo, Samborondon, Ecuador
| | - Gustavo Citera
- Rheumatology Department – Instituto Nacional de Rehabilitación Psicofísica, Buenos Aires, Argentina
| | - Carlos Rios
- Rheumatology Department - Universidad Espiritu Santo, Samborondon, Ecuador
| |
Collapse
|
20
|
Sparks JA, Malspeis S, Hahn J, Wang J, Roberts AL, Kubzansky LD, Costenbader KH. Depression and Subsequent Risk for Incident Rheumatoid Arthritis Among Women. Arthritis Care Res (Hoboken) 2021; 73:78-89. [PMID: 32937012 DOI: 10.1002/acr.24441] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 09/01/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate the association of depression with subsequent risk of rheumatoid arthritis (RA) by serologic phenotype. METHODS We performed a cohort study using pooled data from the Nurses' Health Study (NHS; 1992-2014) and the NHSII (1993-2015). Depression was defined according to the following composite definition: diagnosis by clinician, regular antidepressant use, or a 5-question Mental Health Inventory score of <60 using time-updated questionnaires during follow-up. Incident RA cases met research criteria by medical record review. Information on covariates, including smoking, diet, and body mass index, was obtained using questionnaires. Cox regression estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) for RA risk (overall and by serologic phenotype) according to depression status and adjusted for potential confounders. All analyses included a time separation between assessments of depression and the window for RA risk of at least 4 years to lower the possibility that depressive symptoms due to early RA prior to diagnosis explained any associations. RESULTS Among 195,358 women, we identified 858 cases of incident RA (65% seropositive) over 3,087,556 person-years (median 17.9 years per participant). Compared to women without depression, those with depression had multivariable HRs as follows: 1.28 (95% CI 1.10-1.48) for all RA; 1.12 (95% CI 0.93-1.35) for seropositive RA; and 1.63 (95% CI 1.27-2.09) for seronegative RA. When analyzing components of the composite depression exposure variable, regular antidepressant use was not associated with subsequent seropositive RA (HR 1.21 [95% CI 0.97-1.49]) and was associated with seronegative RA (HR 1.75 [95% CI 1.32-2.32]). CONCLUSION Indicators of depression, specifically antidepressant use, were associated with subsequent increased risk for seronegative RA, and this finding was not explained by measured lifestyle factors prior to clinical presentation.
Collapse
Affiliation(s)
- Jeffrey A Sparks
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Jill Hahn
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jiaqi Wang
- Brigham and Women's Hospital, Boston, Massachusetts
| | - Andrea L Roberts
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Laura D Kubzansky
- Harvard Medical School and Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Karen H Costenbader
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
21
|
Choi HG, Lee JK, Lee MJ, Park B, Sim S, Lee SM. Blindness increases the risk for hip fracture and vertebral fracture but not the risk for distal radius fracture: a longitudinal follow-up study using a national sample cohort. Osteoporos Int 2020; 31:2345-2354. [PMID: 32632509 DOI: 10.1007/s00198-020-05475-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 05/21/2020] [Indexed: 12/14/2022]
Abstract
UNLABELLED The risks for hip fracture and vertebral fracture, but not the risk for distal radius fracture, were significantly higher in the blindness group than in the control group with a maximum 12-year follow-up. PURPOSE To evaluate the influence of visual impairment on the risk for osteoporotic fractures at common sites: hip, thoracic/lumbar vertebra, and distal radius. METHODS This longitudinal follow-up study used a database of a national sample cohort from 2002 to 2013 provided by the Korean National Health Insurance Service. Of a total of 1,125,691 subjects, 3918 patients with visual impairment and age ≥ 50 years were enrolled in a 1:4 ratio; 15,672 control participants were matched for age, sex, income, and region of residence. Stratified Cox proportional-hazards models were used to evaluate the crude and adjusted (for steroid medication, rheumatoid arthritis, depression, osteoporosis, diabetes mellitus, and stroke history) hazard ratios (HRs) for each fracture site. Fracture diagnoses were based on the ICD-10 codes: hip fracture (S720, S721, S722), vertebral fracture (S220, S320), and distal radius fracture (S525). RESULTS The HRs for hip and vertebral fracture were significantly higher in the blindness group (adjusted HR = 2.46, p < 0.001 for hip fracture; adjusted HR = 1.42, p = 0.020 for thoracic/lumbar vertebral fracture) than in the matched control group. However, the HR for distal radius fracture was not higher in the blindness group. The HRs for all three fracture sites were not significantly higher in the non-blindness visual impairment group after adjustment. CONCLUSION The risks for hip fracture and vertebral fracture were significantly higher in the blindness group. However, the risk for distal radius fracture was not related to visual impairment including blindness.
Collapse
Affiliation(s)
- H G Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea
| | - J K Lee
- Department of Orthopaedic Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - M J Lee
- Department of Ophthalmology, Hallym University College of Medicine, Anyang, Republic of Korea
| | - B Park
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
| | - S Sim
- Department of Statistics and Institute of Statistics, Hallym University, 1 Hallymdaehak-gil, Chuncheon-si, Gangwon-do, 24252, Republic of Korea.
| | - S-M Lee
- Department of Cornea, External Disease & Refractive Surgery, HanGil Eye Hospital, Catholic Kwandong University College of Medicine, 35 Bupyeong-daero, Bupyeong-gu, Incheon, 21388, Republic of Korea.
| |
Collapse
|
22
|
Jiang CH, Zhu F, Qin TT. Relationships between Chronic Diseases and Depression among Middle-aged and Elderly People in China: A Prospective Study from CHARLS. Curr Med Sci 2020; 40:858-870. [PMID: 33123901 DOI: 10.1007/s11596-020-2270-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/03/2020] [Indexed: 12/18/2022]
Abstract
Given the rapid increase in the prevalence of chronic diseases in aging populations, this prospective study including 17 707 adults aged ≥45 years from China Health and Retirement Longitudinal Study was used to estimate the associations between chronic disease, multimorbidity, and depression among middle-aged and elderly adults in China, and explore the mediating factors. Depressive symptoms were assessed using the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) questionnaire. Twelve chronic physical conditions, including hypertension, diabetes, dyslipidemia, cancer, chronic lung disease, liver disease, heart failure, stroke, kidney disease, arthritis or rheumatism, asthma, digestive disease were assessed. The prevalence rates for physical multimorbidity and depression (CES-D-10 ≥10) were 43.23% and 36.62%, respectively. Through multivariable logistic models and generalized estimating equation (GEE) models, we found all 12 chronic physical conditions, and multimorbidity were significantly associated with depression. Both mobility problems and chronic pain explained more than 30% of the association for all chronic conditions, with particularly high percentages for stroke (51.56%) and cancer (51.06%) in mobility problems and cancer (53.35%) in chronic pain. Limited activities of daily living (ADL) explained 34.60% of the stroke-cancer relationship, while sleep problems explained between 10.15% (stroke) and 14.89% (chronic lung disease) of the association. Individuals with chronic diseases or multimorbidity are significantly more likely to be depressed. Functional symptoms involving limitations of ADL and mobility difficulties mediated much of the association between chronic diseases and incident depression. These symptoms could be targeted for interventions to ameliorate the incidence of depression among individuals with chronic conditions.
Collapse
Affiliation(s)
- Chun-Hong Jiang
- School of Management, Hubei University of Education, Wuhan, 430205, China
| | - Feng Zhu
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ting-Ting Qin
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| |
Collapse
|
23
|
Wang X, Zhang Z, He X, Meng H, Zhang L, Zhang L, Lou X, Fang P. Mapping publication status and exploring hotspots in a research field: Rheumatoid arthritis with depression. J Adv Nurs 2020; 76:3003-3013. [PMID: 32944987 DOI: 10.1111/jan.14504] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/13/2020] [Accepted: 07/28/2020] [Indexed: 12/12/2022]
Abstract
AIM To make a bibliometric analysis of the current research status and hot spots in the field of rheumatoid arthritis (RA) -related depression. DESIGN Systematic review. METHODS Based on the Web of Science database, studies in the past 5 years from 1 January 2015-5 November 2019 have been included. Data were analysed from annual number of published papers, main research institutions, core authors, core teams and research topics by using bibliometric approaches. RESULTS Related papers (N = 1,073) were obtained. The field of RA-related depression is in a stable development stage, forming core authors and core teams. The epidemiological characteristics, influencing factors, prediction effect and the intervention of RA-related depression are common research directions and themes. The common role of auto-antibodies and inflammatory factors in the development of RA and depression, the risk of cardiovascular events and disease burden caused by RA-related depression are newly emerging research topics. CONCLUSION The RA-related depression has been widely concerned by scholars and the research field is gradually mature. However, the research on the prevention and intervention of RA-related depression is still wanting, which needs to be strengthened. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: The research revealed the most popular institutions, authors, research teams, emerging issues and 'hot topics' in the RA-related depression field, which might suggest avenues for future research in this field.
Collapse
Affiliation(s)
- Xia Wang
- The Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ziyun Zhang
- The Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xifei He
- The Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Heng Meng
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Zhang
- The Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lijuan Zhang
- The Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuejiao Lou
- The Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pengjian Fang
- School of Health and Medicine Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
24
|
Self-care recommendations for patients with rheumatic diseases during the COVID-19 pandemic. Rheumatol Int 2020; 40:1347-1349. [PMID: 32488428 PMCID: PMC7266385 DOI: 10.1007/s00296-020-04614-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/27/2020] [Indexed: 11/22/2022]
|