The relationship between rheumatoid arthritis and depression

Öz

Objective: Rheumatoid arthritis (RA) is the most common chronic, inflammatory arthritis. The reason is still unknown. The purpose of this study is to determine the level of depression in patients with rheumatoid arthritis. Methods: 80 rheumatoid arthritis patients and 63 healthy control subjects were included in the study. Both groups were filled in the Beck depression inventory (BDI) and the Symptom Checklist-90 (SCL-90R). The results obtained from BDI and SCL-90 global symptom index (GSI) and the depression subscales were statistically compared. Results: BDI scores were higher in RA patients (17:35 ± 8:54) than the control group (5.86 ± 3.12). In patients with RA SCL-90 GSI subscale score (1.40 ± 1.86) and depression subscale scores also (1.16 ± 0.68) was higher than the control group (0.59 ± 0.83 and 0.57 ± 0.83). Conclusion: Depression levels in RA patients are significantly higher compared to healthy people according to these findings. Therefore RA patients must approach mutidisipliner including psychiatric treatment.

Anahtar Kelimeler

• Rheumatoid arthritis, depression, chronic disease, depressive symptoms

Romatoid artrit ve depresyon arasındaki ilişki

Öz

Amaç: Romatoid artrit (RA), en sık görülen kronik, inflamatuvar artrittir. Sebebi halen tam olarak bilinmemektedir. Bu çalışmanın amacı romatoid artrit hastalarında depresyon düzeyinin belirlenmesidir. Yöntemler: Çalışmaya 80 romatoid artrit hastası ve 63 sağlıklı kontrol grubu alındı. Her iki gruba Beck depresyon envanteri (BDE) ve Belirti tarama listesi-90 (SCL-90R) sorgulama formu dolduruldu.. BDE\'den ve SCL-90R global semptom indeksi (GSI) ve depresyon alt ölçeklerinden elde edilen sonuçlar istatistiksel olarak karşılaştırıldı. Bulgular: BDE puanları, RA hastalarında (17.35±8.54) kontrol grubuna (5.86±3.12) göre yüksek bulundu. RA hastalarında SCL-90R GSI altölçek puanı (1.40±1.86) ve depresyon altölçek puanı da (1.16±0.68) kontrol grubuna göre (0.59±0.83 ve 0.57±0.83) yüksek bulundu. Sonuç: Bu bulgulara göre RA hastalarında depresyon düzeyi sağlıklı insanlara göre yüksektir. Bu nedenle RA hastalarına psikiyatrik tedaviyi de içeren mutidisipliner yaklaşım gerekmektedir.

Anahtar Kelimeler

• Romatoid artrit, depresyon, kronik hastalık, depresif belirtiler

Kaynakça

1. Song X, Guo S, Chen Y, et al. Association between HLA- DQA1 gene copy number polymorphisms and susceptibil- ity to rheumatoid arthritis in Chinese Han population. J Genet 2014;93:215-218.
2. Tekeoğlu İ, Çiftçi İH, Gürol G, ve ark. Romatoid artrit hasta- lık aktivitesinde tartışmalı belirteç: ortalama platelet hacmi. Yeni Tıp Dergisi 2014;31:106-108.
3. Yen J-H, Chang C-M, Hsu Y-W, et al. A polymorphism of ORAI1 rs7135617, is associated with susceptibility to rheu- matoid arthritis. Mediators Inflamm. 2014;2014:834831.
4. Deighton CM, Walker DJ, Griffiths ID, Roberts DF. The contribution of HLA to rheumatoid arthritis. Clin Genet 1989;36:178-182.
5. Cooles Faye AH, Isaacs J D. Pathophysiology of rheumatoid arthritis. Curr Opin Rheumatol 2011;23: 233-240.
6. Mete HE. Kronik hastalık ve depresyon. Klinik Psikiyatri 2008;11:13-18.
7. Katz PP, Yelin EH. Prevalence and correlates of depressive symptoms among persons with rheumatoid arthiritis. J Rheumatol 1993;20:790-796.
8. Altan L, Bingöl Ü, Sağırkaya Z, et al. Romatoid artritli hasta- larda anksiyete ve depresyon. Romatizma 2004;19:1.

9. Pincus T, Pearce S, McClelland A, et al. Interpretation bias in responses to ambiguous cues in pain patients. J Psychosom Res 1994;38:347-353.
10. Beck AT. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561–571.
11. Hisli N. Validity and reliability for university students of the beck depression inventory. Turk J Psychol 1989;7:3–13.
12. Derogatis LR: SCL-90-R: Administration, Scoring and Pro- cedures Manual for the Revised Version. Baltimore, MD, John Hopkins University School of Medicine, Clinical Psy- chometrics Research Unit, 1977
13. Dağ İ. Belirti Tarama Listesi (SCL-90-R)’ nin üniversite öğrencileri için güvenilirliği ve geçerliliği. Türk Psikiyatri Dergisi 1991;2:5-12.
14. Hawley AJ, Wolfe F. Depression is not more common in rheumatoid arthritis: 10 year longitudinal study of 6153 pa- tients with rheumatic diseases. J Rhematol 1993;20:2025- 2031.
15. Söderlin MK, Hakala M, Nieminen P. Anxiety and depres- sion in a community-based rheumatoid arthritis population. Scand J Rheumatol 2000;29:177-183.
16. Smedstad LM, Vaglum P, Moum T, Kvien K. The relation- ship between psychological distress and traditional clinical variables: A 2 year prospective study of 216 patients with early rheumatoid arthiritis. Br J Rheumatol 1997;36:1304- 1311.
17. Newman SP, Fitzpatrick R, Lamb R, Shipley M. The origins of depressed mood in rheumatoid arthiritis. J Rheumatol 1989;16:740-744.
18. Barlow JH, Cullen LA, Rowe IF. Educational preferences, psychological well-being and self-efficacy among people with rheumatoid arthiritis. Patient Educ Couns 2002;46:11- 19.
19. Kırlı S. Anksiyete bozukluklarının oluşumu ve farmakolo- jik tedavisi, 1.Baskı. Bursa: Psikiyatri ve Sanat Yayınevi, 2000;1-25.
20. Frank RG, Chaney JM, Clay DL, et al. Grambling S. Dys- phoria: A major symptom factor in persons with disability or chronic illness. Psychiatry Res 1992;43:231-241.
21. Von Korff M, Ormel J, Katon W, Lin EH. Disability and de- pression among high utilizes of health care. A longitudinal analysis. Arc Gen Psychiatry 1992;49:91-100.
22. Zautra AJ, Smith BW. Depression and reactivity to stress in older women with rheumatoid arthritis and osteoarthritis. Psychosom Med 2001;63:687-696.
23. Altındağ Ö, Altındağ A, Soran N, Tabur H. Romatoid artrit ve osteoartrit hastalarında yetiyitimi ve depresyon. Klinik Psikofarmakoloji Bülteni 2007;17:24-29.
24. Sarıyıldız MA, Batmaz İ, Kaya MC, et al. Association of the sleep quality with pain, radiological damage, functional status and depressive symptoms in patients with knee os- teoarthritis. J Clin Exp Invest 2013;4;189-194.