Risk of depression in rheumatoid arthritis patients

The authors evaluated the risks of developing depression in patients with rheumatoid arthritis (RA). 

In RA, high levels of immune system proteins are generated, which causes inflammation in the joints. This leads to long-lasting pain. Several studies have reported that, due to the increase in pain levels, RA patients are more likely to suffer from depression. Additionally, depression is shown to be an independent risk factor of death in RA patients. As a result, depression symptoms should be monitored in RA patients.

However, it is important to determine if there is an association between RA and an increased risk of clinical depression (depressive disorders with well-established symptoms). 

The authors aimed to determine the risks of clinical depression in RA patients.

Data from 18,285 participants was used in this study. Out of these, 3,657 were RA patients and 14,628 were control patients (patients without RA and depression). Patients were observed for 10 years to determine if there were new cases of depression.  

205 RA patients and 384 control patients were diagnosed with clinical depression. 80% of RA patients developed depression within 5 years following RA diagnosis. The risk of having depressive disorders was 2.2 times higher in RA patients compared to the control group. Other factors associated with increased risks of depression in RA patients were female sex, heart disease, diabetes and patients with high incomes.

Hyperthyroidism (a condition where the thyroid gland makes excessive thyroid hormone), was found to be an independent risk factor in the development of depression. Patients with hyperthyroidism had a 67% increased risk of being diagnosed with clinical depression.  

The authors concluded that RA patients were more likely to develop clinical depression compared to patients without RA. They also suggested that symptoms of depression should be thoroughly evaluated in RA patients. 

The study did not include several factors which might have increased the risk of developing depression. This includes family history of depression, lifestyle factors, disability, stress, life changing events and childhood trauma, among others.  

Talk to your doctor about an assessment for the symptoms of depression.