title: Increased risk of depression in patients with rheumatoid arthritis: a seven-year population-based cohort study.
abstract: OBJECTIVE
  Rheumatoid arthritis (RA) is a costly and crippling autoimmune disease that can lead to the development of depression, contributing to suboptimal clinical outcomes. However, no longitudinal studies have identified an association between rheumatoid arthritis and subsequent depression. This study aimed to investigate the incidence and risk factors of depression among RA patients in Taiwan.
  
  
  METHODS
  Using Taiwan's National Health Insurance Research Database, we identified 3,698 newly diagnosed RA patients aged 18 years or older, together with 7,396 subjects without RA matched by sex, age and index date, between 2000 and 2004. The incidence of depression and the risk factors among RA cases were evaluated using Cox proportional-hazard regression.
  
  
  RESULTS
  The incidence of depression was 1.74-fold greater in the RA cohort than in the non-RA cohort (11.80 versus 6.89 per 1,000 person-years; p<0.01). Multivariate analysis showed that RA subjects who were female, were older, or had comorbidities such as stroke, chronic kidney disease, or cancer had a significantly greater risk of depression compared with those without these conditions.
  
  
  CONCLUSIONS
  This population-based cohort study showed a strong relationship between RA and a subsequent risk of depression. The findings could be beneficial to healthcare providers for identifying individuals with a higher predisposition for depression, thereby possibly facilitating the provision of an appropriate rehabilitation intervention after RA onset to support the patient's adaptation.
authors: Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
authors: Miao-Chiu
authors: MC
authors: Lin
authors: Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors: How-Ran
authors: HR
authors: Guo
authors: Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
authors: Ming-Chi
authors: MC
authors: Lu
authors: Rehabilitation Counseling Program, Portland State University, Portland, OR, USA.
authors: Hanoch
authors: H
authors: Livneh
authors: Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
authors: Ning-Sheng
authors: NS
authors: Lai
authors: Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors: Tzung-Yi
authors: TY
authors: Tsai
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000523:psychology*; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult