Increased Risk of Depression and Anxiety in Rheumatoid Arthritis Save

Canadian researchers have analyzed population data and shown that the incidence and prevalence of depression, anxiety  and bipolar disorders are elevated in the rheumatoid arthritis (RA) patients compared to a matched population.

Estimates on the prevalence of depression and anxiety in RA patients vary widely in the literature. Thus, investigators analyzed population‐based administrative health data from Manitoba, Canada, to identify RA patients and a 5:1 matched control population to estimate the incidence and prevalence of depression, anxiety disorder, bipolar disorder, and schizophrenia. 

Among 10,206 incident cases of RA and 50,960 matched individuals, adjusted incidence rates were reported:

• Depression: was higher in the RA patients (incidence rate ratio [IRR] 1.46 [95% confidence interval (95% CI) 1.35–1.58]). The lifetime and annual period prevalence of depression was also higher in RA.
• Anxiety: was higher in RA patients (IRR 1.24 [95% CI 1.15–1.34]). The lifetime and annual period prevalence of anxiety was also higher in RA 
• Bipolar disorder was also higher (IRR 1.21 [95% CI 1.00–1.47]).
• Not significant: the frequency of schizophrenia did not differ between groups (IRR 0.96 [95% CI 0.61–1.50]).

The risks of depression, anxiety disorder, and bipolar disorder have not changed over time, despite substantial changes in the clinical management of RA over the 20‐year study period.

Clinicians should be aware that women and those of lower socioeconomic status are at particularly increased risk of these disorders.