title: Serious psychological distress in U.S. adults with arthritis.
abstract: BACKGROUND
  Arthritis and mental health disorders are leading causes of disability commonly seen by health care providers. Several studies demonstrate a higher prevalence of anxiety and depression in persons with arthritis versus those without arthritis.
  
  
  OBJECTIVE
  Determine the national prevalence of serious psychological distress (SPD) and frequent anxiety or depression (FAD) in adults with arthritis, and in adults with arthritis, identify risk factors associated with SPD.
  
  
  METHODS
  Cross-sectional data from the 2002 National Health Interview Survey, an in-person household interview survey, were used to estimate the prevalence of SPD and FAD in adults with (n=6,829) and without (n=20,676) arthritis. In adults with arthritis, the association between SPD and sociodemographic, clinical, and functional factors was evaluated using multivariable logistic regression.
  
  
  RESULTS
  The prevalence of SPD and FAD in adults with arthritis is significantly higher than in adults without arthritis (5.6% vs 1.8% and 26.2% vs 10.7%, P<.001, respectively). In adults with arthritis, SPD was significantly associated with younger age, lower socioeconomic status, divorce/separation, recurrent pain, physical inactivity, having functional or social limitations, and having comorbid medical conditions. Adults aged 18 to 44 years were 6.5 times more likely to report SPD than those 65 years or older, and adults with recurrent pain were 3 times more likely to report SPD than those without recurrent pain.
  
  
  CONCLUSIONS
  Serious psychological distress and FAD affect persons with arthritis and should be addressed in their treatment. Younger adults with arthritis, and those with recurrent pain or either functional or social limitations, may be at higher risk for SPD.
authors.affiliation: Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, Los Angeles, CA 90012, USA. mshih@ladhs.org
authors.forename: Margaret
authors.initials: M
authors.lastname: Shih
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Hootman
authors.forename: Tara W
authors.initials: TW
authors.lastname: Strine
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Chapman
authors.forename: Teresa J
authors.initials: TJ
authors.lastname: Brady
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D014481:United States