title: Anxiety disorder among rheumatoid arthritis patients: Insights from real-life data.
abstract: Psychiatric disorders occur in a considerable proportion of patients with rheumatoid arthritis (RA), often reflecting the difficulties of these patients in coping with a chronic debilitating disorder.
  
  
  
  To evaluate the proportion of anxiety disorder in RA patients using a large database analysis.
  
  
  
  The study was designed as a case-control population-based study using data from the Clalit Health Services (CHS) database. Patients were defined as having RA or anxiety disorder when there was at least one documented diagnosis identified by the International Classification of Diseases-9 (ICD-9) from the medical records. The proportion of anxiety disorder was compared between RA patients and controls. A logistic regression model was used to estimate the association between RA and anxiety disorder in a multivariate analysis adjusted for age, gender and socioeconomic status (SES).
  
  
  
  The study included 11,782 patients with RA and 57,973 age- and sex-frequency matched controls. The proportion of anxiety in RA patients was higher than in controls (7.1% vs 6.3%, p=0.001). In multivariate analysis, RA was found to be independently associated with anxiety (OR 1.11 [95%CI 1.03-1.20], p=0.01). Our study has some shortcomings, as its cross-sectional nature does not allow to make inferences about a causal relationship between RA and anxiety.
  
  
  
  Our study confirms the higher proportion of anxiety in RA patients, especially young women with low SES. Physicians should be aware of such findings and, therefore, apply proper screening strategies.
authors.affiliation: Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer, Israel; The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Abdulla
authors.initials: A
authors.lastname: Watad
authors.affiliation: School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
authors.forename: Nicola L
authors.initials: NL
authors.lastname: Bragazzi
authors.affiliation: Padeh and Ziv hospitals, Bar-Ilan, Faculty of Medicine, Zefat, Israel.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Adawi
authors.affiliation: The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: Gali
authors.initials: G
authors.lastname: Aljadeff
authors.affiliation: Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer, Israel; The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel. Electronic address: howard.amital@sheba.health.gov.il.
authors.forename: Howard
authors.initials: H
authors.lastname: Amital
authors.affiliation: Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Comaneshter
authors.affiliation: Chief Physician's Office, Clalit Health Services Tel Aviv, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Arnon D
authors.initials: AD
authors.lastname: Cohen
authors.affiliation: Sackler Faculty of Medicine, Tel-Aviv University, Israel; Ness Ziona-Beer Yaacov Mental Health Center, Beer-Yaacov, Israel.
authors.forename: Daniela
authors.initials: D
authors.lastname: Amital
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000150:complications*; D001172:Arthritis, Rheumatoid / Q000523:psychology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012923:Social Class
keywords: Anxiety; Autoimmune diseases; Case-control study; Comorbidity; Rheumatoid arthritis