Social, Health, and Age Differences Associated with Depressive Disorders in Women with Rheumatoid Arthritis

Identification and Treatment Optimization of Comorbid Depression in Rheumatoid Arthritis

Patients with rheumatoid arthritis (RA) suffer from high rates of depression but depression often remains undiagnosed and untreated among RA patients. Because of its high prevalence and its profound impact on functional disability and health-related quality of life, prompt recognition and management of comorbid depression is urgently needed in patients with RA. Rheumatologists face the challenge of addressing depression in their clinical interactions with patients. The purpose of this paper is to present the prevalence of comorbid depression in RA, to delineate the consequences of depression among RA patients, to discuss the barriers to the identification of depression among RA patients, and to outline a set of recommendations to identify and treat comorbid depression that could be implemented within the rheumatology clinic setting. A comprehensive approach to the management of both physical and mental health needs of RA patients can aid in improving patient overall quality of life. New clinical protocols should be developed to include routine depression screening as part of the rheumatology visit. Patient education to address misconceptions, knowledge gaps, and destigmatize depression is also recommended. More counseling resources, including emotional support groups, are necessary to provide treatment for those suffering from depression. Such interventions could help mitigate disability, improve quality of life, patient function, and overall satisfaction.

Men's experiences of rheumatoid arthritis: an inductive thematic analysis

OBJECTIVES

There is a lack of evidence for understanding the clinical needs of men with rheumatoid arthritis (RA). This study investigated the psychosocial experience of this group, to inform clinical practice and generate further research.

METHODS

Twelve adult male patients with RA were interviewed once. Interview data were analysed using an inductive thematic analysis procedure. Categories and themes were validated by a second researcher and a male RA patient research partner.

RESULTS

Four themes were generated: loss of power and control; use of power and control; adjustment; influencing factors (age, pain, medication, relationships and health staff communication). Loss of power and control left participants vulnerable to low mood. Participants asserted power and control over RA by adopting a problem-solving stance in order to continue with ordinary life. An accepting attitude characterized the adjustment theme where men respected their bodies' limits. The final theme consisted of factors which influenced these three themes.

DISCUSSION

These data suggest that when RA results in loss of personal power and control, patients experience distress, which they may not express to their clinicians. Findings indicate directions for further research investigating the possibility that men and women may have differing clinical needs.

Research on persistent pain in late life: current topics and challenges

Older women often experience pain in their daily lives. This article provides an overview of topics addressed in the geriatric pain research published between 1999 and 2004. New areas of emphasis of research have emerged such as the recognition of body mass and weight as a factor in persistent pain, while other areas have expanded, including the focus on pain among elders with cognitive impairments and the use of alternative treatment approaches. Understanding of pain in late life is hindered by study samples that lack diversity, treatment approaches that are narrowly focused, and a lack of attention to quality of life issues.