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New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis – Implications from the prospective multicenter VADERA II study

OBJECTIVES: 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-repor...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6538160/
https://www.ncbi.nlm.nih.gov/pubmed/31136632
http://dx.doi.org/10.1371/journal.pone.0217412
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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_facet 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 Englbrecht, Matthias
collection PubMed
description OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. CLINICAL TRIAL REGISTRATION NUMBER: This study is registered in the Deutsches Register Klinischer Studien (DRKS00003231) and ClinicalTrials.gov (NCT02485483).
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spelling pubmed-65381602019-06-05 New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis – Implications from the prospective multicenter VADERA II study 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 PLoS One Research Article OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. CLINICAL TRIAL REGISTRATION NUMBER: This study is registered in the Deutsches Register Klinischer Studien (DRKS00003231) and ClinicalTrials.gov (NCT02485483). Public Library of Science 2019-05-28 /pmc/articles/PMC6538160/ /pubmed/31136632 http://dx.doi.org/10.1371/journal.pone.0217412 Text en © 2019 Englbrecht et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
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
New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis – Implications from the prospective multicenter VADERA II study
title New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis – Implications from the prospective multicenter VADERA II study
title_full New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis – Implications from the prospective multicenter VADERA II study
title_fullStr New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis – Implications from the prospective multicenter VADERA II study
title_full_unstemmed New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis – Implications from the prospective multicenter VADERA II study
title_short New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis – Implications from the prospective multicenter VADERA II study
title_sort new insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis – implications from the prospective multicenter vadera ii study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6538160/
https://www.ncbi.nlm.nih.gov/pubmed/31136632
http://dx.doi.org/10.1371/journal.pone.0217412
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