title: History of depressive episodes as a risk factor for illness severity in early inflammatory arthritis.
abstract: OBJECTIVE
  Psychosocial research in arthritis consistently demonstrates a relationship between depression and disease characteristics such as severity of illness and physical disability. In this study, we examine how a history of clinical depression identified through diagnostic interviews influences disease outcome measures in patients with early inflammatory arthritis (EIA) in the absence of current depression.
  
  
  METHODS
  Patients in the early phase (more than 6-weeks, less than 1-year duration) of inflammatory arthritis were recruited from a larger EIA registry, which recorded sociodemographic data, current depressive symptoms and measures of disease severity. Current and history of major depression was assessed by a structured clinical interview. Eighty-one patients without current major depression were divided into two groups: 28 with and 53 without a history of depression.
  
  
  RESULTS
  There were no significant differences between the two groups in age, sex, education, income, or level of current depressive symptoms. Compared with patients with no history of major depression, those with a history of depressive episodes had higher self-ratings of disease activity and were assessed as having more severe disease and poorer physical functioning by their physicians.
  
  
  CONCLUSIONS
  This study indicates that a history of major depression represents a risk factor for disease severity in EIA. This may reflect an enduring physiological effect of depression that influences subsequent inflammatory arthritis or an underlying shared process between these two disease entities.
authors.affiliation: Department of Psychiatry, Jewish General Hospital and McGill University, Montreal, Canada. karl.looper@mcgill.ca
authors.forename: Karl
authors.initials: K
authors.lastname: Looper
authors.forename: Sally
authors.initials: S
authors.lastname: Mustafa
authors.forename: Phyllis
authors.initials: P
authors.lastname: Zelkowitz
authors.forename: Margaret
authors.initials: M
authors.lastname: Purden
authors.forename: Murray
authors.initials: M
authors.lastname: Baron
mesh_terms: D000328:Adult; D000368:Aged; D001168:Arthritis / Q000175:diagnosis*; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index