title: Clinical and psychosocial factors associated with depression and anxiety in Singaporean patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To assess the frequency of, and factors associated with, depression and anxiety in Singaporean patients with rheumatoid arthritis (RA).
  
  
  METHODS
  One hundred RA patients were recruited in a cross-sectional study. Socio-demographics, severity of anxiety and depression, disease activity, levels of serological markers and health-related quality of life were analyzed.
  
  
  RESULTS
  Twenty-six percent presented with anxiety, 15% with depression and 11% with both. Univariate regression showed that age (P = 0.039), Disease Activity Scale (DAS-28) (P < 0.001), number of medications (P < 0.001) and rheumatoid factor (RF) (P < 0.001) were positively associated with severity of depression, while income (P = 0.001), education (P = 0.029), self-perceived social support (P = 0.007), Short form 12 (SF-12) physical health (P < 0.001) and SF-12 mental health (P < 0.001) were negatively associated with severity of depression. After adjustment for confounding factors in multivariate regression, income (β = -0.347, P = 0.018), RF (β = 0.304, P = 0.043) and SF-12 mental health (β = -0.501 P = 0.001) remained significantly associated with depression. Univariate regression showed that DAS-28 (P = 0.009), number of medications (P = 0.004) and RF (P = 0.043) were positively associated with anxiety, while income (P = 0.022), self-perceived social support (P = 0.04), SF-12 physical health (P < 0.001) and SF-12 mental health (P < 0.001) were negatively associated with anxiety. After adjustment for confounding factors, no factors remained significantly associated with anxiety.
  
  
  CONCLUSIONS
  Low income, high levels of RF and poor mental health were associated with depression in RA. Our findings may help to formulate depression screening strategies. Further research is required to identify the role of RF in depression.
authors.affiliation: Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. pcmrhcm@nus.edu.sg
authors.forename: Roger C M
authors.initials: RC
authors.lastname: Ho
authors.forename: Erin H Y
authors.initials: EH
authors.lastname: Fu
authors.forename: Anna N C
authors.initials: AN
authors.lastname: Chua
authors.forename: Alicia A C
authors.initials: AA
authors.lastname: Cheak
authors.forename: Anselm
authors.initials: A
authors.lastname: Mak
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*; D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*; D002681:China / Q000208:ethnology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D055809:Illness Behavior; D007194:India / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D012217:Rheumatoid Factor / Q000097:blood; D012720:Severity of Illness Index; D012846:Singapore / Q000453:epidemiology; D055815:Young Adult
chemical_list: D012217:Rheumatoid Factor