title: Anxiety and depression in patients with osteoarthritis: impact and management challenges.
abstract: BACKGROUND
  Anxiety and depression are common psychological comorbidities that impact the quality of life (QoL) of patients. In this systematic review, we 1) determined the impact of anxiety and depression on outcomes in patients with osteoarthritis (OA) and 2) summarized unique challenges these comorbidities present to current OA management.
  
  
  METHODS
  A systematic literature search was performed using the OVID Medline and EMBASE databases until April 2016. Full-text research articles published in English from the year 2000 onward with a sample size of >100 were included in this review. Eligible research articles were reviewed and the following data were extracted: study author(s), year of publication, study design, and key findings.
  
  
  RESULTS
  A total of 38 studies were included in the present review. The present study found that both anxiety and/or depression were highly prevalent among patients with OA. Patients with OA diagnosed with these comorbidities experienced more pain, had frequent hospital visits, took more medication, and reported less optimal outcomes. Management strategies in the form of self-care, telephone support, audio/video education programs, and new pharmacotherapies were reported with favorable results.
  
  
  CONCLUSIONS
  Anxiety and depression adversely impact the QoL of patients with OA. Physicians/caregivers are highly recommended to consider these comorbidities in patients with OA. Ultimately, a holistic individualized management approach is necessary to improve patient outcomes.
authors.affiliation: Division of Genetics and Development, Krembil Research Institute.
authors.forename: Anirudh
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Division of Orthopaedic Surgery, Toronto Western Hospital, Toronto, ON, Canada.
authors.forename: Prtha
authors.initials: P
authors.lastname: Kudesia
authors.affiliation: Division of Orthopaedic Surgery, Toronto Western Hospital, Toronto, ON, Canada.
authors.forename: Qian
authors.initials: Q
authors.lastname: Shi
authors.affiliation: Division of Orthopaedic Surgery, Toronto Western Hospital, Toronto, ON, Canada.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Gandhi
keywords: anxiety; depression; impact; management; osteoarthritis