title: Identifying target areas of treatment for depressed early inflammatory arthritis patients.
abstract: BACKGROUND
  The goal of this study was to identify target areas for psychosocial intervention for depressed patients with early inflammatory arthritis.
  
  
  METHODS
  One hundred and sixty-five patients with early inflammatory arthritis (> or =1 joint with synovitis for > or =6 weeks and <1 year with a diagnosis of either rheumatoid or undifferentiated inflammatory arthritis) were referred to the McGill Early Arthritis Registry (McEAR) by their rheumatologist. McEAR patients agree to periodic physical exams and to completing questionnaires. Demographic, disease and psychosocial factors were compared between patients screening positive and negative for depression using independent samples t tests and Pearson's chi(2) test and then were entered into a logistic regression model examining the likelihood of screening positive for depression.
  
  
  RESULTS
  Thirty-eight (23%) patients screened positive for depressive symptoms. Patients with symptoms of depression had significantly worse disease severity, disability, and pain, engaged in more emotional preoccupation coping, had less self-efficacy for pain and other arthritis-related symptoms, smaller social networks and were less satisfied with social support than the nondepressed group. In logistic regression analyses, pain and emotional preoccupation coping were positively related to the likelihood of screening positive for depression, while satisfaction with social support was negatively related to the likelihood of screening positive for depression
  
  
  CONCLUSIONS
  Higher pain levels, emotional preoccupation coping and dissatisfaction with social support were related to depressive symptoms in this study. This suggests that the optimal care of depressed patients with inflammatory arthritis would include a psychosocial approach that addresses these specific target areas.
authors.affiliation: Department of Medicine, McGill University, Montreal, Que., Canada. patricia.dobkin@mcgill.ca
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Dobkin
authors.forename: Marta
authors.initials: M
authors.lastname: Filipski
authors.forename: Karl
authors.initials: K
authors.lastname: Looper
authors.forename: Orit
authors.initials: O
authors.lastname: Schieir
authors.forename: Murray
authors.initials: M
authors.lastname: Baron
mesh_terms: D000223:Adaptation, Psychological; D001172:Arthritis, Rheumatoid / Q000523:psychology* / Q000628:therapy; D019090:Case Management; D015928:Cognitive Behavioral Therapy; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011788:Quality of Life