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Can depression hinder remission in rheumatoid arthritis and psoriatic arthritis?

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Created On: 03/02/2025

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Depression can impede recovery in rheumatoid arthritis and psoriatic arthritis. These patients often have more tender joints, higher pain, poorer health, and slightly higher inflammatory markers. Addressing depressive symptoms is key for effective management.

Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are chronic inflammatory ailments that affect millions. While disease activity and treatment adherence play a key role in remission, mental health conditions like depression and anxiety may also impact treatment outcomes.

A recent study issued in “Rheumatology” involved 400 RA and 367 PsA patients. Depression and anxiety were determined via the hospital anxiety and depression scale (HADS), with scores above 7 indicating possible disorders. Remission was marked by disease activity scores (44-joint Disease Activity Score [DAS44] < 1.6 for RA and Disease Activity Index for Psoriatic Arthritis [DAPSA] ≤ 4 for PsA).

Mixed models were used to analyze the impact of depression and anxiety on remission and disease activity over a 2-year period. It was noted that 20% of RA and 18% of PsA patients had possible depression; 30% of RA and 23% of PsA patients had possible anxiety. After adjusting for anxiety, depression was linked to lower odds of remission over 2 years [odds ratio 0.45 for RA, odds ratio 0.24 for PsA]. Anxiety showed no association with remission after adjusting for depression.

Depression/anxiety was tied to higher pain, tender joint count, worse general health, and slightly elevated inflammation, but did not affect joint swelling. Depressive symptoms in RA and PsA patients were observed to be associated with a lower chance of remission, highlighting the importance of screening and addressing mental health in managing these chronic conditions.