WASHINGTON — Severity of mental health symptoms predicted the severity of inflammatory arthritis disease, according to an abstract presented at the American College of Rheumatology Annual Meeting.
“High anxiety and depression are associated with higher levels of pain, fatigue and poor function over time,” Renee El-Gabalawy, PhD, assistant professor in the Department of Anesthesia and Clinical Health Psychology at the University of Manitoba in Winnipeg, said in her presentation. “There seems to be an independent effect for depressive symptoms.”
El-Gabalawy and colleagues assessed 148 patients who belonged to a prospective longitudinal early arthritis cohort from 2012 through 2015. The mean age of the patients was 57.7 years and 72% were female. Each year, patients self-reported the presence of depression or anxiety, while researchers assessed the severity of symptoms using the patient reported outcomes measurement information system (PROMIS). At any time, there was at least a 10.7% presence of current mood disorder and 6.3% presence of anxiety. The researchers also assessed arthritis activity using VAS score for pain fatigue, a modified health assessment questionnaire (mHAQ), swollen-28 joint count, tender-28 joint count, Lansbury-weighted joint count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and clinical disease activity index (CDAI). Afterward, the researchers examined both the cross-sectional and longitudinal relationship between mental health and arthritis severity.
The researchers found fatigue was associated with both depression (beta = 0.27) and anxiety (beta = 0.197). Increasing symptoms of anxiety and depression were associated with pain, fatigue, CDAI, tender joint count, mHAQ and the Lansbury index, with correlation values ranging from 0.156 to 0.514. Investigators found ESR, DAS28 and CRP were linked with severity of depressive symptoms. Worsening anxiety (beta = 0.212) and depressive symptoms (beta = 0.207) were also associated with CRP.
“What might be occurring here is that — in the case of depression with disease progression — we might see a larger role in exacerbation in maintenance of activity,” El-Gabalawy said. “Whereas for anxiety, we might see a larger role in earlier stages of this disease.” – by Will Offit
El-Gabalawy, et al. Abstract #3084. Presented at: American College of Rheumatology Annual Meeting; Nov. 11-16, 2016; Washington.
Disclosure: El-Gabalawy reports she is an employee of the University of Manitoba.