TY  - JOUR
A1  - Englbrecht, Matthias Emanuel Richard Peter
A1  - Alten, Rieke
A1  - Aringer, Martin
A1  - Baerwald, Christoph
A1  - Burkhardt, Harald
A1  - Eby, Nancy
A1  - Flacke, Jan-Paul
A1  - Fliedner, Gerhard
A1  - Henkemeier, Ulf
A1  - Hofmann, Michael W.
A1  - Kleinert, Stefan
A1  - Kneitz, Christian
A1  - Krüger, Klaus
A1  - Pohl, Christoph
A1  - Schett, Georg
A1  - Schmalzing, Marc
A1  - Tausche, Anne-Kathrin
A1  - Tony, Hans-Peter
A1  - Wendler, Jörg
T1  - New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis – implications from the prospective multicenter VADERA II study
T2  - PLoS one
N2  - 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.
Clinical trial registration number: This study is registered in the Deutsches Register Klinischer Studien (DRKS00003231) and ClinicalTrials.gov (NCT02485483).
KW  - Depression
KW  - Rheumatoid arthritis
KW  - Questionnaires
KW  - NSAIDs
KW  - Mental health and psychiatry
KW  - Psychometrics
KW  - Rheumatology
KW  - Emotions
Y1  - 2019
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/50444
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-504447
SN  - 1932-6203
N1  - Copyright: © 2019 Englbrecht et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
VL  - 14
IS  - (5): e0217412
SP  - 1
EP  - 13
PB  - PLoS
CY  - Lawrence, Kan.
ER  -