A STUDY OF PAIN AND DEPRESSION IN PATIENTS WITH RHEUMATOID ARTHRITIS

BACKGROUND Rheumatoid arthritis is a psychosomatic illness, in which psychological factors play a major role in disease process. Comorbid depression and physical pain are major contributing factors (Chandarna et al, 1 Covic et al), 2 but they are unevaluated and under detected (Brend Lowe et al). 3 Aims and Objectives-To study the prevalence of depression and its association with pain symptoms in rheumatoid arthritis patients. MATERIALS AND METHODS Inclusion Criteria-Patients above 18 years with rheumatoid arthritis and without having acute severe physical problems, mental retardation, delirium or dementia. Study Tools-ICD-10 DCR, Brief pain inventory, MADRS. RESULTS Out of the 100 patients, 86% are females and 66% belong to 30 - 50 age group and most of them are using steroids (74%) and are having less than 10 years duration of illness (93%). Severe pain intensity score (BPI 10 - 20) is present in 30%, pain interference score is more than 20 in 46% of patients and the percentage of pain reduction with medication is only less than 30% in 38% of study population. Depression is present in 22% and the mean MADRS score is 32. BPI pain intensity score (p value.0008), pain interference score (p value.000) and pain reduction score (p value.0003) are significantly related to depression. Intensity of depression assessed by MADRS is significantly correlated with above variables. CONCLUSION Depression is a common comorbidity in rheumatoid arthritis patients and the level of pain, interference of pain in daily life and reduction of pain with medication is significantly related to depression. The severity of depression is significantly correlated with the above variables.