Prevalence and determinants of psychiatric disorders in patients with rheumatoid arthritis.
BACKGROUND
Rheumatoid arthritis (RA) is the most common chronic rheumatological disorder among southern Chinese patients in Hong Kong, with an estimated prevalence of 0.33%-0.35%. The resulting chronic pain, disability, social stress, and isolation contribute to the development of psychiatric symptoms.


OBJECTIVE
The authors identify the prevalence and determining factors of psychiatric disorders in patients with RA.


METHODS
Consecutive RA patients (N=200) were recruited from a rheumatology outpatient clinic. Psychiatric disorders were diagnosed by a psychiatrist using the Chinese-bilingual Structured Clinical Interview for DSM-IV Axis I disorders, Patient Research Version. Sociodemographic and clinical data and subjective health status and perceived social support data were also collected. Factors associated with the occurrence of psychiatric disorders were studied by multivariate analysis.


RESULTS
A total of 47 patients were diagnosed with a current psychiatric disorder (depressive disorders, 14.5%; anxiety disorders, 13.0%; schizophrenia, 0.5%). Major depressive disorder and generalized anxiety disorder were the commonest current mood and anxiety disorders, respectively. Independent predictors for a current psychiatric disorder were poverty and perceived poor social support. Limited social interaction, perceived poor social support, high pain intensity, and a family history of psychiatric disorders were independently associated with a current depressive disorder, whereas poverty and perceived poor social support were associated with a current anxiety disorder.


CONCLUSIONS
Depression and anxiety are common in Chinese patients with RA. Patients who lack social support or rely on economic assistance are more prone to the development of psychiatric disorders.
Lok
Eugenia Yung Ching
EY
correspondence and M.D., FRCP, Chief of Rheumatology, Dept. of Medicine, Tuen Mun Hospital, New Territories, Hong Kong, SAR, China. ccmok2005@yahoo.com.
Mok
Chi Chiu
CC
Cheng
Chi Wai
CW
Cheung
Eric Fuk Chi
EF
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D015588:Observer Variation; D016017:Odds Ratio; D010147:Pain Measurement / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012944:Social Support; D012959:Socioeconomic Factors; D055815:Young Adult