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Predictors of depression in a multiethnic cohort of patients with rheumatoid arthritis
Arthritis Care and Research , 11/03/09
Margaretten M et al. – Patients with RA who experience depression have worse health outcomes. This study identifies predictors of depression in an ethnically and racially diverse population of patients with RA. Identifying associated predictors of depression in a diverse population of patients with RA can help guide treatment, which should include preventing disability and decreased function as well as targeting depressive symptoms more specifically in patients with RA.
Methods- Patients with RA in prospective cohort at San Francisco General Hospital outpatient rheumatology clinic included if they were age 18 years, met American College of Rheumatology classification criteria for RA, had Health Assessment Questionnaire (HAQ) score collected, and had RA-specific Disease Activity Score performed by a rheumatologist
- Outcome variable was depression score measured by Patient Health Questionnaire 9 (PHQ-9), self-report questionnaire validated to correlate with diagnosis of major depression
- 349 clinical visits for 172 patients included in analysis
- 40% of patients scored 10 on PHQ-9 during at least one clinic visit, which corresponds to symptom severity of at least moderate depression
- Mean PHQ-9 score was 7, corresponding to symptom severity of mild depression
- In multivariate analysis, higher HAQ scores associated with depression, and Asians had lower depression scores compared with Hispanic, white, and African American subjects
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