Prevalence of and factors associated with depression and anxiety in patients with rheumatoid arthritis: A multicenter prospective cross-sectional study

Aim To investigate the prevalence of and factors associated with depression and anxiety in patients with rheumatoid arthritis (RA). Methods This prospective cross-sectional study included patients who were consecutively enrolled in the Siriraj Rheumatoid Arthritis Registry or the Thai Army Rheumatoid Arthritis Cohort during the September 2016 to March 2018 study period. Demographic data and clinical variables, including disease activity, functional status, health-related quality of life, and cognitive function, were collected. Depression and anxiety were assessed using the Thai version of the Hospital Anxiety and Depression Scale (Thai HADS). Results Four hundred and sixty-four patients were included. Mean age was 59 years, median disease duration was 9.9 years, and 85% of patients were female. Based on the Thai HADS cutoff value of 8 or higher, 12.5% and 14.5% of patients had some degree of depression and anxiety, respectively. Multivariate analysis revealed global health score (risk ratio [RR]: 0.98, P = .001) to be the only factor independently negatively associated with depression. Regarding anxiety, functional disability (RR: 2.46, P = .004) and married status (RR: 2.43, P = .009) were significantly associated with increased risk, whereas disease duration of 10 years or more (RR: 0.45, P = .007) and global health score (RR: 0.97, P < .001) were significantly associated with decreased risk of developing anxiety. Conclusion Depression and anxiety are common in patients with RA. Patients' perceptions of their current health are significantly related to mood disorders. Therefore, mental health status, especially mood disturbances, should be addressed in routine practice to improve quality of life in RA.