New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis - Implications from the prospective multicenter VADERA II study
To investigate the prevalence of depressive symptoms in rheumatoid arthritis (RA) patients using two previously validated questionnaires in a large patient sample, and to evaluate depressive symptoms in the context of clinical characteristics (e.g. remission of disease) and patient-reported impact o...
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| Veröffentlicht in: | PloS one 2019-05, Vol.14 (5), p.e0217412-e0217412 |
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| creator | Englbrecht, Matthias Alten, Rieke Aringer, Martin Baerwald, Christoph G Burkhardt, Harald Eby, Nancy Flacke, Jan-Paul Fliedner, Gerhard Henkemeier, Ulf Hofmann, Michael W Kleinert, Stefan Kneitz, Christian Krüger, Klaus Pohl, Christoph Schett, Georg Schmalzing, Marc Tausche, Anne-Kathrin Tony, Hans-Peter Wendler, Jörg |
| description | To investigate the prevalence of depressive symptoms in rheumatoid arthritis (RA) patients using two previously validated questionnaires in a large patient sample, and to evaluate depressive symptoms in the context of clinical characteristics (e.g. remission of disease) and patient-reported impact of disease.
In this cross-sectional study, the previously validated Patient Health Questionnaire (PHQ-9) and Beck-Depression Inventory II (BDI-II) were used to assess the extent of depressive symptoms in RA patients. Demographic background, RA disease activity score (DAS28), RA impact of disease (RAID) score, comorbidities, anti-rheumatic therapy and antidepressive treatment, were recorded. Cut-off values for depressive symptomatology were PHQ-9 ≥5 or BDI-II ≥14 for mild depressive symptoms or worse and PHQ-9 ≥ 10 or BDI-II ≥ 20 for moderate depressive symptoms or worse. Prevalence of depressive symptomatology was derived by frequency analysis while factors independently associated with depressive symptomatology were investigated by using multiple logistic regression analyses. Ethics committee approval was obtained, and all patients provided written informed consent before participation.
In 1004 RA-patients (75.1% female, mean±SD age: 61.0±12.9 years, mean disease duration: 12.2±9.9 years, DAS28 (ESR): 2.5±1.2), the prevalence of depressive symptoms was 55.4% (mild or worse) and 22.8% (moderate or worse). Characteristics independently associated with depressive symptomatology were: age 2 (OR = 10.54) and presence of chronic pain (OR = 3.25). Of patients classified as having depressive symptoms, only 11.7% were receiving anti-depressive therapy.
Mild and moderate depressive symptoms were common in RA patients according to validated tools. In routine clinical practice, screening for depression with corresponding follow-up procedures is as relevant as incorporating these results with patient-reported outcomes (e.g. symptom state), because the mere assessment of clinical disease activity does not sufficiently reflect the prevalence of depressive symptoms.
This study is registered in the Deutsches Register Klinischer Studien (DRKS00003231) and ClinicalTrials.gov (NCT02485483). |
| doi_str_mv | 10.1371/journal.pone.0217412 |
| format | Article |
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In this cross-sectional study, the previously validated Patient Health Questionnaire (PHQ-9) and Beck-Depression Inventory II (BDI-II) were used to assess the extent of depressive symptoms in RA patients. Demographic background, RA disease activity score (DAS28), RA impact of disease (RAID) score, comorbidities, anti-rheumatic therapy and antidepressive treatment, were recorded. Cut-off values for depressive symptomatology were PHQ-9 ≥5 or BDI-II ≥14 for mild depressive symptoms or worse and PHQ-9 ≥ 10 or BDI-II ≥ 20 for moderate depressive symptoms or worse. Prevalence of depressive symptomatology was derived by frequency analysis while factors independently associated with depressive symptomatology were investigated by using multiple logistic regression analyses. Ethics committee approval was obtained, and all patients provided written informed consent before participation.
In 1004 RA-patients (75.1% female, mean±SD age: 61.0±12.9 years, mean disease duration: 12.2±9.9 years, DAS28 (ESR): 2.5±1.2), the prevalence of depressive symptoms was 55.4% (mild or worse) and 22.8% (moderate or worse). Characteristics independently associated with depressive symptomatology were: age <60 years (OR = 1.78), RAID score >2 (OR = 10.54) and presence of chronic pain (OR = 3.25). Of patients classified as having depressive symptoms, only 11.7% were receiving anti-depressive therapy.
Mild and moderate depressive symptoms were common in RA patients according to validated tools. In routine clinical practice, screening for depression with corresponding follow-up procedures is as relevant as incorporating these results with patient-reported outcomes (e.g. symptom state), because the mere assessment of clinical disease activity does not sufficiently reflect the prevalence of depressive symptoms.
This study is registered in the Deutsches Register Klinischer Studien (DRKS00003231) and ClinicalTrials.gov (NCT02485483).</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0217412</identifier><identifier>PMID: 31136632</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Aged ; Analysis ; Antidepressants ; Arthritis ; Arthritis, Rheumatoid - epidemiology ; Arthritis, Rheumatoid - psychology ; Autoimmune diseases ; Biology and Life Sciences ; Chronic pain ; Comorbidity ; Complications and side effects ; Coping ; Cross-Sectional Studies ; Demographics ; Depression (Mood disorder) ; Depression - epidemiology ; Ethics ; Fatigue ; Female ; Frequency analysis ; Germany - epidemiology ; Health ; Health surveys ; Hospitals ; Humans ; Immunology ; Informed consent ; Internal medicine ; Longitudinal studies ; Male ; Medical research ; Medical screening ; Medicine ; Medicine and Health Sciences ; Mental depression ; Middle Aged ; Pain ; Patients ; Prevalence ; Prevalence studies (Epidemiology) ; Prospective Studies ; Questionnaires ; Regression analysis ; Remission ; Research and Analysis Methods ; Rheumatoid arthritis ; Rheumatoid factor ; Rheumatology ; Risk Factors ; Signs and symptoms ; Sleep ; Social Sciences ; Surveys and Questionnaires ; Therapy</subject><ispartof>PloS one, 2019-05, Vol.14 (5), p.e0217412-e0217412</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Englbrecht et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Englbrecht et al 2019 Englbrecht et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-27fabad26dc854aaedc166ff4b38912c099004530e5c16e0a486d7d4f1a70a8c3</citedby><cites>FETCH-LOGICAL-c692t-27fabad26dc854aaedc166ff4b38912c099004530e5c16e0a486d7d4f1a70a8c3</cites><orcidid>0000-0003-0228-7183</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6538160/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6538160/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31136632$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>ten Klooster, Peter M.</contributor><creatorcontrib>Englbrecht, Matthias</creatorcontrib><creatorcontrib>Alten, Rieke</creatorcontrib><creatorcontrib>Aringer, Martin</creatorcontrib><creatorcontrib>Baerwald, Christoph G</creatorcontrib><creatorcontrib>Burkhardt, Harald</creatorcontrib><creatorcontrib>Eby, Nancy</creatorcontrib><creatorcontrib>Flacke, Jan-Paul</creatorcontrib><creatorcontrib>Fliedner, Gerhard</creatorcontrib><creatorcontrib>Henkemeier, Ulf</creatorcontrib><creatorcontrib>Hofmann, Michael W</creatorcontrib><creatorcontrib>Kleinert, Stefan</creatorcontrib><creatorcontrib>Kneitz, Christian</creatorcontrib><creatorcontrib>Krüger, Klaus</creatorcontrib><creatorcontrib>Pohl, Christoph</creatorcontrib><creatorcontrib>Schett, Georg</creatorcontrib><creatorcontrib>Schmalzing, Marc</creatorcontrib><creatorcontrib>Tausche, Anne-Kathrin</creatorcontrib><creatorcontrib>Tony, Hans-Peter</creatorcontrib><creatorcontrib>Wendler, Jörg</creatorcontrib><title>New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis - Implications from the prospective multicenter VADERA II study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To investigate the prevalence of depressive symptoms in rheumatoid arthritis (RA) patients using two previously validated questionnaires in a large patient sample, and to evaluate depressive symptoms in the context of clinical characteristics (e.g. remission of disease) and patient-reported impact of disease.
In this cross-sectional study, the previously validated Patient Health Questionnaire (PHQ-9) and Beck-Depression Inventory II (BDI-II) were used to assess the extent of depressive symptoms in RA patients. Demographic background, RA disease activity score (DAS28), RA impact of disease (RAID) score, comorbidities, anti-rheumatic therapy and antidepressive treatment, were recorded. Cut-off values for depressive symptomatology were PHQ-9 ≥5 or BDI-II ≥14 for mild depressive symptoms or worse and PHQ-9 ≥ 10 or BDI-II ≥ 20 for moderate depressive symptoms or worse. Prevalence of depressive symptomatology was derived by frequency analysis while factors independently associated with depressive symptomatology were investigated by using multiple logistic regression analyses. Ethics committee approval was obtained, and all patients provided written informed consent before participation.
In 1004 RA-patients (75.1% female, mean±SD age: 61.0±12.9 years, mean disease duration: 12.2±9.9 years, DAS28 (ESR): 2.5±1.2), the prevalence of depressive symptoms was 55.4% (mild or worse) and 22.8% (moderate or worse). Characteristics independently associated with depressive symptomatology were: age <60 years (OR = 1.78), RAID score >2 (OR = 10.54) and presence of chronic pain (OR = 3.25). Of patients classified as having depressive symptoms, only 11.7% were receiving anti-depressive therapy.
Mild and moderate depressive symptoms were common in RA patients according to validated tools. In routine clinical practice, screening for depression with corresponding follow-up procedures is as relevant as incorporating these results with patient-reported outcomes (e.g. symptom state), because the mere assessment of clinical disease activity does not sufficiently reflect the prevalence of depressive symptoms.
This study is registered in the Deutsches Register Klinischer Studien (DRKS00003231) and ClinicalTrials.gov (NCT02485483).</description><subject>Aged</subject><subject>Analysis</subject><subject>Antidepressants</subject><subject>Arthritis</subject><subject>Arthritis, Rheumatoid - epidemiology</subject><subject>Arthritis, Rheumatoid - psychology</subject><subject>Autoimmune diseases</subject><subject>Biology and Life Sciences</subject><subject>Chronic pain</subject><subject>Comorbidity</subject><subject>Complications and side effects</subject><subject>Coping</subject><subject>Cross-Sectional Studies</subject><subject>Demographics</subject><subject>Depression (Mood disorder)</subject><subject>Depression - epidemiology</subject><subject>Ethics</subject><subject>Fatigue</subject><subject>Female</subject><subject>Frequency analysis</subject><subject>Germany - epidemiology</subject><subject>Health</subject><subject>Health surveys</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunology</subject><subject>Informed consent</subject><subject>Internal medicine</subject><subject>Longitudinal studies</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical screening</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Mental depression</subject><subject>Middle Aged</subject><subject>Pain</subject><subject>Patients</subject><subject>Prevalence</subject><subject>Prevalence studies (Epidemiology)</subject><subject>Prospective Studies</subject><subject>Questionnaires</subject><subject>Regression analysis</subject><subject>Remission</subject><subject>Research and Analysis Methods</subject><subject>Rheumatoid arthritis</subject><subject>Rheumatoid factor</subject><subject>Rheumatology</subject><subject>Risk Factors</subject><subject>Signs and symptoms</subject><subject>Sleep</subject><subject>Social 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insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis - Implications from the prospective multicenter VADERA II study</title><author>Englbrecht, Matthias ; Alten, Rieke ; Aringer, Martin ; Baerwald, Christoph G ; Burkhardt, Harald ; Eby, Nancy ; Flacke, Jan-Paul ; Fliedner, Gerhard ; Henkemeier, Ulf ; Hofmann, Michael W ; Kleinert, Stefan ; Kneitz, Christian ; Krüger, Klaus ; Pohl, Christoph ; Schett, Georg ; Schmalzing, Marc ; Tausche, Anne-Kathrin ; Tony, Hans-Peter ; Wendler, Jörg</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-27fabad26dc854aaedc166ff4b38912c099004530e5c16e0a486d7d4f1a70a8c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Analysis</topic><topic>Antidepressants</topic><topic>Arthritis</topic><topic>Arthritis, Rheumatoid - epidemiology</topic><topic>Arthritis, Rheumatoid - 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Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Englbrecht, Matthias</au><au>Alten, Rieke</au><au>Aringer, Martin</au><au>Baerwald, Christoph G</au><au>Burkhardt, Harald</au><au>Eby, Nancy</au><au>Flacke, Jan-Paul</au><au>Fliedner, Gerhard</au><au>Henkemeier, Ulf</au><au>Hofmann, Michael W</au><au>Kleinert, Stefan</au><au>Kneitz, Christian</au><au>Krüger, Klaus</au><au>Pohl, Christoph</au><au>Schett, Georg</au><au>Schmalzing, Marc</au><au>Tausche, Anne-Kathrin</au><au>Tony, Hans-Peter</au><au>Wendler, Jörg</au><au>ten Klooster, Peter M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis - Implications from the prospective multicenter VADERA II study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-05-28</date><risdate>2019</risdate><volume>14</volume><issue>5</issue><spage>e0217412</spage><epage>e0217412</epage><pages>e0217412-e0217412</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To investigate the prevalence of depressive symptoms in rheumatoid arthritis (RA) patients using two previously validated questionnaires in a large patient sample, and to evaluate depressive symptoms in the context of clinical characteristics (e.g. remission of disease) and patient-reported impact of disease.
In this cross-sectional study, the previously validated Patient Health Questionnaire (PHQ-9) and Beck-Depression Inventory II (BDI-II) were used to assess the extent of depressive symptoms in RA patients. Demographic background, RA disease activity score (DAS28), RA impact of disease (RAID) score, comorbidities, anti-rheumatic therapy and antidepressive treatment, were recorded. Cut-off values for depressive symptomatology were PHQ-9 ≥5 or BDI-II ≥14 for mild depressive symptoms or worse and PHQ-9 ≥ 10 or BDI-II ≥ 20 for moderate depressive symptoms or worse. Prevalence of depressive symptomatology was derived by frequency analysis while factors independently associated with depressive symptomatology were investigated by using multiple logistic regression analyses. Ethics committee approval was obtained, and all patients provided written informed consent before participation.
In 1004 RA-patients (75.1% female, mean±SD age: 61.0±12.9 years, mean disease duration: 12.2±9.9 years, DAS28 (ESR): 2.5±1.2), the prevalence of depressive symptoms was 55.4% (mild or worse) and 22.8% (moderate or worse). Characteristics independently associated with depressive symptomatology were: age <60 years (OR = 1.78), RAID score >2 (OR = 10.54) and presence of chronic pain (OR = 3.25). Of patients classified as having depressive symptoms, only 11.7% were receiving anti-depressive therapy.
Mild and moderate depressive symptoms were common in RA patients according to validated tools. In routine clinical practice, screening for depression with corresponding follow-up procedures is as relevant as incorporating these results with patient-reported outcomes (e.g. symptom state), because the mere assessment of clinical disease activity does not sufficiently reflect the prevalence of depressive symptoms.
This study is registered in the Deutsches Register Klinischer Studien (DRKS00003231) and ClinicalTrials.gov (NCT02485483).</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31136632</pmid><doi>10.1371/journal.pone.0217412</doi><tpages>e0217412</tpages><orcidid>https://orcid.org/0000-0003-0228-7183</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2019-05, Vol.14 (5), p.e0217412-e0217412 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2231406842 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Aged Analysis Antidepressants Arthritis Arthritis, Rheumatoid - epidemiology Arthritis, Rheumatoid - psychology Autoimmune diseases Biology and Life Sciences Chronic pain Comorbidity Complications and side effects Coping Cross-Sectional Studies Demographics Depression (Mood disorder) Depression - epidemiology Ethics Fatigue Female Frequency analysis Germany - epidemiology Health Health surveys Hospitals Humans Immunology Informed consent Internal medicine Longitudinal studies Male Medical research Medical screening Medicine Medicine and Health Sciences Mental depression Middle Aged Pain Patients Prevalence Prevalence studies (Epidemiology) Prospective Studies Questionnaires Regression analysis Remission Research and Analysis Methods Rheumatoid arthritis Rheumatoid factor Rheumatology Risk Factors Signs and symptoms Sleep Social Sciences Surveys and Questionnaires Therapy |
| title | New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis - Implications from the prospective multicenter VADERA II study |
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