Gender-Specific Effects of Depression on Functional Disability in Rheumatoid Arthritis: A Prospective Study

We examined the prospective impact of depression on objective ratings of disability as a function of gender in a sample of persons with rheumatoid arthritis. Forty-two individuals from an outpatient rheumatology clinic completed measures of depression, disability, and pain over the course of 1 year. A physician's assistant completed objective measures of functional disability following a routine physical examination. Results demonstrated a significant main effect for gender on Time 2 objective ratings of disability (after controlling for disease variables and self-report indices of pain and disability), indicating that physician assistants rated female participants as more disabled than male participants. Importantly, the interaction of gender and Time 1 depression contributed significant variance to Time 2 disability. Findings suggest that women, relative to men, may experience greater declines in functional capacity over time, independent of self-perceptions of pain and disability, and that depression plays a significant role in this process. Discussion focuses on treatment considerations for health care teams, with particular focus on women's adjustment of to RA.