Increased risk of depression in patients with rheumatoid arthritis: a seven-year population-based cohort study

Authors

  • Miao-Chiu Lin Buddhist Tzu Chi Medical Foundation; Dalin Tzu Chi Hospital; Department of Nursing
  • How-Ran Guo National Cheng Kung University Hospital; Department of Occupational and Environmental Medicine
  • Ming-Chi Lu Tzu Chi University; School of Medicine
  • Hanoch Livneh Portland State University; Rehabilitation Counseling Program
  • Ning-Sheng Lai Tzu Chi University; School of Medicine
  • Tzung-Yi Tsai Department of Nursing; Tzu Chi College of Technology

DOI:

https://doi.org/10.6061/clinics/2015(02)04

Abstract

OBJECTIVE: Rheumatoid arthritis (RA) is a costly and crippling autoimmune disease that can lead to the development of depression, contributing to suboptimal clinical outcomes. However, no longitudinal studies have identified an association between rheumatoid arthritis and subsequent depression. This study aimed to investigate the incidence and risk factors of depression among RA patients in Taiwan. METHODS: Using Taiwan's National Health Insurance Research Database, we identified 3,698 newly diagnosed RA patients aged 18 years or older, together with 7,396 subjects without RA matched by sex, age and index date, between 2000 and 2004. The incidence of depression and the risk factors among RA cases were evaluated using Cox proportional-hazard regression. RESULTS: The incidence of depression was 1.74-fold greater in the RA cohort than in the non-RA cohort (11.80 versus 6.89 per 1,000 person-years; p<0.01). Multivariate analysis showed that RA subjects who were female, were older, or had comorbidities such as stroke, chronic kidney disease, or cancer had a significantly greater risk of depression compared with those without these conditions. CONCLUSION: This population-based cohort study showed a strong relationship between RA and a subsequent risk of depression. The findings could be beneficial to healthcare providers for identifying individuals with a higher predisposition for depression, thereby possibly facilitating the provision of an appropriate rehabilitation intervention after RA onset to support the patient's adaptation.

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Published

2015-02-01

Issue

Section

Clinical Sciences

How to Cite

Lin, M.-C., Guo, H.-R., Lu, M.-C., Livneh, H., Lai, N.-S., & Tsai, T.-Y. (2015). Increased risk of depression in patients with rheumatoid arthritis: a seven-year population-based cohort study . Clinics, 70(2), 91-96. https://doi.org/10.6061/clinics/2015(02)04