Depression and depressive symptoms in rheumatoid arthritis patients: an analysis of their occurrence and determinants

The objectives were to determine the differences in depressive symptoms anddepression between rheumatoid arthritis (RA) and osteoarthritis (OA)patients, and to analyse the contribution of sociodemographic and clinicalvariables to depression in RA patients. The responses of 60 Egyptian RApatients and 40 patients with OA of the knees to the Symptom Checklist-90-RDepression subscale were compared. The proportions of patients from bothgroups confirmed by a psychiatric interview to be clinically depressedaccording to the DSM-III-R criteria were also compared. The contributionsof sociodemographic and disease variables to depressive symptoms andclinical depression in RA patients were explored by multiple linear andlogistic regression, respectively. RA patients showed significantly higherdepression scores than OA patients (P = 0.001). The difference wasunaffected by controlling for the effects of age, sex, disease duration andthe sociodemographic covariates. A depressive disorder was clinicallyconfirmed in 23% of RA patients and 10% of OA patients. The erythrocytesedimentation rate (ESR), being unmarried and an urban residence weresignificant predictors of depressive symptoms (P < 0.05), while beingunmarried (P < 0.05, OR = 2.1) and HAQ disability (P < 0.01, OR =3.8) were significant predictors of clinical depression in RA patients. RApatients have significantly more depressive symptoms and tend to be moreclinically depressed than OA patients. The contribution of somesociodemographic and clinical variables to depression in RA patients wasmodest, albeit significant.