Quantifying the burden of emotional ill‐health amongst patients referred to a specialist rheumatology service

Objectives. (1) To determine the prevalence of emotional disorders (DSM IV depression, anxiety and panic disorders) amongst patients referred to a rheumatology out‐patient service and the proportion of these detected by the rheumatologist. (2) To test the hypotheses that emotional disorders are associated with (i) broad categories of rheumatological diagnosis (systemic, inflammatory vs non‐systemic, non‐inflammatory), (ii) female gender, (iii) greater symptom burden and disability and (iv) markers of socio‐economic deprivation. Methods. A cross‐sectional study was made of consecutive newly referred attenders at a hospital‐based, regional rheumatology service. Emotional disorders, pain, health status and socio‐economic factors were assessed by questionnaire. The letter to the referrer was scrutinized for the rheumatological diagnosis and mention of emotional disorder. Results. A total of 256 patients were eligible and 203 (79%) participated. The sample was 69% female, had a mean age of 50 yr and 68 patients (33.5%) had one or more emotional disorders. Only a minority were detected. There was no association with type of rheumatological diagnosis. Patients with an emotional disorder were more likely to be female (81 vs 62%; P