Anxiety and depression are prevalent in patients with inflammatory arthritis; comorbid mental health issues were linked to impaired self-management behavior.

A Danish, cross-sectional study focused on the possible effect of anxiety and depression on self-management behavior in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and spondylarthritis (SpA). Over 12,000 patients identified from the Danish Rheumatology database and National Patient Registry completed an electronic questionnaire. Patients had a mean age of 62 and a disease duration of 12 years. Women represented 63.4% of the study population. Possible anxiety and depression were both defined by a score between 8 and 10 on the Hospital Anxiety and Depression Scale (HADS), while a score of 11 or greater was used for definite cases. These findings were presented at EULAR 2023, held May 31-June 2, in Italy.

The prevalence of anxiety varied among the different groups: 34.5% in SpA, 32.1% in PsA, and 22.1% in RA. Depression was present in similar proportions, with prevalence of 27.2% in PsA, 26.4% in SpA, and 18.6% in RA. Being a woman, having basic education, being younger than 55 years, or being recently diagnosed (less than 3 years) was associated with a higher prevalence of anxiety and depression.

“Patients with clinical levels of anxiety and depression symptoms were more likely to have low levels of self-management behavior for all included measures,” Sofie Bech Vestergaard revealed. Thus, treatment adherence, patient activation in health care, and physical activity were significantly lower in those suffering from anxiety or depression. Moreover, Vestergaard highlighted that patients with definite depression had marked difficulties handling new situations concerning their health condition, compared with patients without depression (OR, 7.09; 95% CI, 6.11-8.22). “We need a systematic approach to identify those patients who suffer from anxiety and depression and refer them appropriately. We may need to develop new types of interventions to dedicate to these patients,” Jette Primdahl commented on these results.

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