title: Disability and patient's appraisal of general health contribute to depressed mood in rheumatoid arthritis in a large clinical study in Japan.
abstract: The aim of this study was to evaluate the factors responsible for depressed mood in rheumatoid arthritis (RA). Clinical and laboratory measures were collected from 4558 RA patients enrolled in a large clinical cohort study for RA conducted at the Institute of Rheumatology, Tokyo Women's Medical University (IORRA study). A two-question depressed screening included in the U.S. Preventive Services Task Force recommendation were utilized to identify "depressed patients." A total of 1875 (41.1%) were identified as "depressed patients" who presented with symptoms suggestive of depression. Patient's Visual Analog Scale (VAS) for general health (43.3 mm vs 24.6 mm, P < 0.0001) and pain (40.9 mm vs 23.8 mm, P < 0.0001) and the disability index scores measured by the Health Association Questionnaire (HAQ) (0.986 vs 0.574, P < 0.0001) were significantly higher in depressed patients than in nondepressed patients. The presence of three or more comorbidities (odds ratio [OR] 2.157, P < 0.0001), infection (OR 1.754, P < 0.0001), and joint surgery (OR 1.878, P < 0.0001) were significantly correlated with depressed mood in RA. The results of the Generalized Linear Model analysis showed that HAQ disability index (P < 0.0001) and patient's VAS for general health (P < 0.0001) were also strongly and significantly associated to the response variable "probability of depressed patients." Patient appraisal of poor general health and greater disability were associated with depressed mood in RA.
authors.affiliation: Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan. ayakonkj@ior.twmu.ac.jp
authors.forename: Ayako
authors.initials: A
authors.lastname: Nakajima
authors.forename: Shigeo
authors.initials: S
authors.lastname: Kamitsuji
authors.forename: Akira
authors.initials: A
authors.lastname: Saito
authors.forename: Eiichi
authors.initials: E
authors.lastname: Tanaka
authors.forename: Katsuji
authors.initials: K
authors.lastname: Nishimura
authors.forename: Naoshi
authors.initials: N
authors.lastname: Horikawa
authors.forename: Norio
authors.initials: N
authors.lastname: Ozaki
authors.forename: Taisuke
authors.initials: T
authors.lastname: Tomatsu
authors.forename: Masako
authors.initials: M
authors.lastname: Hara
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Kamatani
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yamanaka
mesh_terms: D001172:Arthritis, Rheumatoid / Q000523:psychology* / Q000601:surgery; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000523:psychology*; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D007239:Infections; D007564:Japan; D008297:Male; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D016017:Odds Ratio; D010147:Pain Measurement; D011795:Surveys and Questionnaires