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

被引：31

作者：

Englbrecht, Matthias ^{[1
]}

Alten, Rieke ^{[2
]}

Aringer, Martin ^{[3
]}

Baerwald, Christoph G. ^{[4
]}

Burkharde, Harald ^{[5
]}

Eby, Nancy ^{[6
]}

Flacke, Jan-Paul ^{[7
]}

Fliedner, Gerhard ^{[8
]}

Henkemeier, Ulf ^{[5
]}

Hofmann, Michael W. ^{[9
]}

Kleinert, Stefan ^{[10
,11
]}

Kneitz, Christian ^{[12
,13
]}

Krueger, Klaus ^{[14
]}

Pohl, Christoph ^{[2
]}

Schett, Georg ^{[1
]}

Schmalzing, Marc ^{[11
]}

Tausche, Anne-Kathrin ^{[3
]}

Tony, Hans-Peter ^{[11
]}

Wendler, Joerg ^{[10
]}

机构：

[1] Friedrich Alexander Univ Erlangen Nurnberg FAU, Univ Klinikum Erlangen, Dept Internal Med Rheumatol & Immunol 3, Erlangen, Germany

[2] Charite Univ Med Berlin, Schlosspk Klin, Internal Med, Rheumatol, Berlin, Germany

[3] Tech Univ Dresden, Univ Med Ctr Carl Gustav Carus, Med 3, Dresden, Germany

[4] Univ Hosp Leipzig, Dept Med Neurol & Dermatol, Rheumatol Unit, Leipzig, Germany

[5] Univ Hosp Frankfurt Main Goethe Univ, Div Rheumatol, Frankfurt, Germany

[6] Ams Adv Med Serv GmbH, Biostat, Mannheim, Germany

[7] Roche Pharma AG, Med Dept Rheumatol, Grenzach Wyhlen, Germany

[8] Rheumatol Schwerpunktpraxis, Rheumatol, Osnabruck, Germany

[9] Chugai Pharma Europe Ltd, Med Dept Rheumatol, Frankfurt, Germany

[10] Rheumatol Schwerpunktpraxis, Rheumatol, Erlangen, Germany

[11] Univ Hosp Wuerzburg, Rheumatol Clin Immunol Dept, Internal Med 2, Wurzburg, Germany

[12] Rheumatol Schwerpunktpraxis, Schwerin, Germany

[13] Klinikum Sudstadt Rostock, Med Rheumatol Immunol, Rostock, Germany

[14] Praxiszentrum St Bonifatius, Rheumatol, Munich, Germany

来源：

PLOS ONE | 2019年 / 14卷 / 05期

关键词：

PAIN; ABSENTEEISM; FATIGUE; IMPACT; PRODUCTIVITY; VALIDATION; ANXIETY; COSTS; PHQ-9; WORK;

D O I：

10.1371/journal.pone.0217412

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

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 follow-up 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.

引用

页数：13

共 41 条

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