Worse self-management in patients with inflammatory arthritis in the presence of comorbid anxiety or depression

A high prevalence of mental health issues was found in Danish registry data that investigated patients with inflammatory arthritis. The presence of anxiety or depression was associated with a higher likelihood of self-management impairment.

“Little is known on the mental health in patients with inflammatory arthritis,” Ms Sofie Bech Vestergaard (Aarhus University Hospital, Denmark) informed [1]. This is why the Danish cross-sectional study focused on the possible effect of anxiety and depression on self-management behaviour in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and spondylarthritis (SpA). “We know that poor mental health is associated with overall poor health, that is why it is such an important area,” Prof. Jette Primdahl (IRS Danish Hospital for Rheumatic Diseases, Denmark) underlined in her comment on the study [2].

Over 12,000 patients identified from the Danish Rheumatology database and National Patient Registry completed an electronic questionnaire [1]. Patients had a mean age of 62 and a disease duration of 12 years. Women represented 63.4% of the study population. Possible anxiety and depression were both defined by a score between 8 and 10 on the Hospital Anxiety and Depression Scale (HADS), while a score of ≥11 was used for definite cases.

The prevalence of anxiety varied among the different groups: 34.5% in SpA, 32.1% in PsA, and 22.1% in RA. Depression was present in somewhat similar proportions, with a prevalence of 27.2% in PsA, 26.4% in SpA, and 18.6% in RA. Being a woman, having basic education, being under 55 years, or being recently diagnosed (less than 3 years) was associated with a higher prevalence of anxiety and depression.

“Patients with clinical levels of anxiety and depression symptoms were more likely to have low levels of self- management behaviour for all included measures,” Ms Vestergaard revealed. Thus, treatment adherence, patient activation in healthcare, and physical activity were significantly lower in those suffering from anxiety or depression. Moreover, Ms Vestergaard highlighted that patients with definite depression had marked difficulties handling new situations concerning their health condition, compared with patients without depression (OR 7.09; 95% CI 6.11–8.22). “We need a systematic approach to identify those patients who suffer from anxiety and depression and refer them appropriately. We may need to develop new interventions to dedicate to these patients,” Prof. Primdahl advocated in light of these results [2].

1. Vestergaard SB, et Self-management behaviour, anxiety and depression in patients with inflammatory arthritis – a cross-sectional nationwide study among >12,000 Danish patients. OP0176, EULAR 2023, 31 May–3 June, Milan, Italy.

2. Primdahl Press conference, EULAR 2023, 31 May–3 June, Milan, Italy.

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Posted on 31 July, 202327 March, 2024