Anxiety, depression prevalent in people with RA

Individuals with rheumatoid arthritis (RA) are at an increased risk of developing anxiety or both depression and anxiety, according to a study.

A total of 1,012 individuals with RA and 1,012 matched controls (mean age 55.9 years, 68.38 percent female) were included in this population-based study. A temporal increase was observed in anxiety and concomitant anxiety and depression from 2005 to 2014, compared with 1985 to 1994, for those with and without RA.

Compared with controls, individuals with RA showed a rising incidence of anxiety (hazard ratio [HR], 1.27, 95 percent confidence interval [CI], 0.86‒1.88) and co-occurring anxiety and depression (HR, 1.49, 95 percent CI, 0.96‒2.33). Such trend was more noticeable among seropositive patients with RA (anxiety: HR, 4.01, 95 percent CI, 2.21‒7.30).

“The increasing occurrence of anxiety and cooccurring anxiety and depression suggests rising awareness and diagnosis of these disorders,” the investigators said. “Adding to stable but high rates of depression diagnoses, individuals with RA now have evidence of a widening gap in mental health diagnoses that clinicians should address.”

In this study, RA patients who met the 1987 American College of Rheumatology criteria between 1985 and 2014 were identified using the Rochester Epidemiology Project. Eligible participants were matched 1:1 with non-RA comparators based on age, sex, and calendar year of RA incidence. The investigators followed these patients until death, migration, or 31 December 2020.

The International Classification of Diseases, 9th and 10th revision code sets were used to define anxiety and depression. Finally, trends in the occurrence of depression and anxiety diagnoses and concomitant anxiety and depression were compared using Cox models, adjusted for potential confounders.