THU0591-HPR The Longitudinal Impact of Persistent Depression on Physical Health Outcomes in Rheumatoid Arthritis

Background Depression is highly prevalent in RA and is associated with increased mortality, disability and healthcare costs [1, 2]. There is limited evidence assessing the longitudinal impact of depression on RA outcomes, particularly objectively-reported clinical outcomes. Objectives To assess the impact of persistent depression on physical health outcomes over a 2-year follow-up period. Methods A secondary data analysis of a clinical trial (CARDERA) was performed [3]. Depression and physical health outcomes were measured at baseline and 6-montly intervals for 2-years. Depression was measured using the EQ-5D, and patients were categorised into 4 groups: 1) never depressed; 2) depressed at 50% of time-points; and 4) depressed at every time-point. Physical health outcomes were: Larsen score; tender joint count (TJC); swollen joint count (SJC); ESR; assessor and patient global assessments (AGA/PGA); HAQ; pain; and DAS-28. Results Data was available for 379 patients. Patients' mean age was 54.1 (12.3), and 68.3% of the sample were female. In total, 25.9% were never depressed, 36.9% were depressed 50% of the time, and 15.8% were depressed at every time-point. Table 1. Fully adjusted multilevel models for physical health outcomes (effect size), with depression persistence as predictor variable Larsen score SJC ESR AGA DAS-28 HAQ TJC PGA Pain Never Depressed – – – – – – – – – Depressed 50% −0.09 0.24 0.09 0.52*** 0.56*** 0.52*** 0.37*** 0.64*** 0.42** Always Depressed −0.16* 0.30 0.15 0.84*** 0.89*** 0.73*** 0.60*** 1.10*** 0.93*** SJC, swollen joint count; ESR, erythrocyte sedimentation rate; AGA, assessor global assessment; DAS-28, disease activity schedule with 28 joint; HAQ, health assessment questionnaire; TJC, tender joint count; PGA patient global assessment. *Significant at p