title: Cardiovascular disease and psychological morbidity among rheumatoid arthritis patients.
abstract: OBJECTIVE
  To examine whether patients with rheumatoid arthritis (RA) with co-morbid cardiovascular disease (CVD) have different psychological morbidity (and psychosocial risk factors for it) compared with RA patients without co-morbid CVD.
  
  
  METHODS
  Patients with RA and co-morbid CVD (n = 44; hypertension alone for n = 27) were compared with RA patients without CVD (n = 110). Differences in psychological morbidity (depression and anxiety) and psychosocial risk factors for this (arthritis self-efficacy, acceptance, social support and optimism) were examined while controlling statistically for medical and demographic covariates.
  
  
  RESULTS
  Groups did not differ on RA duration, RA activity, marital status or socioeconomic status, but RA patients with co-morbid CVD were older, less likely to be female and less likely to be in employment than those without CVD. RA patients with co-morbid CVD had significantly higher depression and were more likely to score above cut-offs for depression than RA patients without CVD. No differences existed in anxiety, although anxiety appeared to be more common than depression. Low optimism was identified as a possible psychosocial risk factor for depression.
  
  
  CONCLUSIONS
  RA patients with co-morbid CVD have higher depression than RA patients without CVD; low optimism is a potentially modifiable risk factor that may mediate this difference. RA patients with co-morbid CVD may benefit from systematic screening for depression and targeted intervention if necessary.
authors.affiliation: University of Birmingham, School of Psychology, UK. GJT884@bham.ac.uk
authors.forename: G J
authors.initials: GJ
authors.lastname: Treharne
authors.forename: E D
authors.initials: ED
authors.lastname: Hale
authors.forename: A C
authors.initials: AC
authors.lastname: Lyons
authors.forename: D A
authors.initials: DA
authors.lastname: Booth
authors.forename: M J
authors.initials: MJ
authors.lastname: Banks
authors.forename: N
authors.initials: N
authors.lastname: Erb
authors.forename: K M
authors.initials: KM
authors.lastname: Douglas
authors.forename: D L
authors.initials: DL
authors.lastname: Mitton
authors.forename: G D
authors.initials: GD
authors.lastname: Kitas
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001007:Anxiety / Q000209:etiology*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000523:psychology*; D001294:Attitude to Health; D002318:Cardiovascular Diseases / Q000150:complications / Q000523:psychology*; D003863:Depression / Q000209:etiology*; D004651:Employment; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000523:psychology; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D012307:Risk Factors; D020377:Self Efficacy; D012737:Sex Factors; D012944:Social Support