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Rheumatology
Original research
Depression: a common comorbidity in women with rheumatoid arthritis—results from an Austrian cross-sectional study
  1. Judith Sautner1,
  2. Rudolf Puchner2,
  3. Alois Alkin3,
  4. Herwig Pieringer4
  1. 1 Rheumatology private practice, Stockerau, Austria
  2. 2 Private practice, Wels, Upperaustria, Austria
  3. 3 Centre of Excellence in Medicine, Linz, Austria
  4. 4 Diakonissen Hospital Linz, Linz, UK
  1. Correspondence to Dr Judith Sautner; judith.sautner90{at}gmail.com

Abstract

Objectives Previous research showed that depression is common in rheumatoid arthritis (RA). However, the prevalence very much depends on different assessment tools and sociocultural differences, respectively. The main study aim and research question was to investigate the proportion of depressive symptoms in Austrian female patients with RA.

Setting A nationwide multicentre study with seven secondary care centres all over Austria (hospital-based rheumatological outpatient clinics and private practices).

Participants 319 patients with RA and 306 healthy controls (HCO), all female Caucasians, were asked to complete a Beck’s Depression Inventory–Fast Screen (BDI-FS). Patients and HCO were ≥18 years. Patients had to fulfil the 2010 classification criteria for RA. In addition, disease activity, disability, medication, drinking of alcoholic beverages, smoking and occupational status were evaluated.

Primary and secondary outcome measures A BDI-FS cut-off value of ≥4, per definition, indicates the presence of a depressive symptomatology.

Results The return rate of questionnaires was high: 235/319 (73.7%) in patients with RA and 180/306 (58.8%), ending up with 392 complete questionnaires from 223 patients with RA (69.9%) and 169 HCO (55.2%). The BDI-FS was significantly higher in patients with RA (median BDI-FS 2 (IQR 0–4) vs median 1 (IQR 0–2) in HCO, p<0.001). BDI-FS scores from ≥4, which by definition indicate depression, were found in 29.6% of patients with RA and 12.4% of HCO (p<0.001). Depressive symptoms were strongly associated with disease activity (Clinical Disease Activity Index, p<0.001) and disability (Health Assessment Questionnaire, p<0.005). No association of depressive symptoms with age, alcohol consumption, smoking, occupational status or use of medication was found.

Conclusions One-third of female patients with RA showed depressive symptoms. Depression was significantly higher in female patients with RA than in female HCO and was strongly associated with disease activity and disability. It would be of interest to address the same question in male participants.

  • rheumatoid arthritis
  • depression & mood disorders
  • disease activity
  • comorbidities
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-033958

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    Footnotes

    • Contributors JS and RP contributed equally to this publication. RP contributed to study conception, design, methods and planning. HP and AA completed all statistical analyses. JS drafted the manuscript and managed revisions. All authors contributed in interpretation of the data and approved the final manuscript.

    • Funding This research was supported by an unrestricted industrial grant from Pfizer Austria (grant no. WI205954).

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Ethics approval Ethics Committee of Upper Austria (approval no. L-26-15).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement The de-identified participant data are stored at the Centre of Excellence in Medicine in Linz, Austria and are available on reasonable request from RP (rudolf.puchner@cc-net.at).