Depression in rheumatoid arthritis patients linked to social status
Rheumatoid arthritis (RA) patients with low socio-economic status are at a higher risk for depression.
RA is a chronic autoimmune disease that can cause functional limitations and may lead to physical disability in many patients. Previous research has shown that 10 percent to 40 percent of RA patients experience depression, which is associated with worse outcomes, including greater risk of heart attack, suicide, and death.
To examine the relationship between functional limitation, socio-economic inequality, and depression in RA patients in order to better identify those patients at higher risk for depression, researchers in America analysed data from 824 hospital or clinic visits made by 466 RA patients. The researchers also looked at measures of socio-economic status, such as race, income, education and health access. They found that 37 percent of RA patients had moderate to severe depression, as measured by a health questionnaire and had fairly high levels of functional impairment and disease activity.
There were significant differences between depressed and non-depressed patients in terms of race, physical limitations, treatment with disease modifying anti-rheumatic drugs and care at a public versus university hospital.
Differences in depression severity were not affected by gender, age, disease duration, steroid use and dose or biological therapy. For the same level of disability, patients with low socio-economic status were more likely to experience depression. The study recommends that detection and documentation of the differing effects of disability on depression between patients of different socioeconomic status can help treating physicians improve health outcomes by initiating appropriate and timely treatment for depression.
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