Mental Health

Older adults with chronic MSK pain report lower physical health—but better mental health—than younger peers. Fewer missed work days, too. Is this resilience, adaptation, or shifting expectations with age? POS0402 @RheumNow #EULAR2025

Jiha Lee @JihaRheum( View Tweet )

Presenteeism and absenteeism in RA aren’t just about joints. In this UK study, comorbid anxiety, depression, and OA drove lost productivity. Treating RA is not enough —holistic management matters. POS0403 @RheumNow #EULAR2025

Jiha Lee @JihaRheum( View Tweet )

The relation between RA, comorbidities and presenteism NRAS survey 891 RA pts 75% had at least one comorbidity Absenteeism more likely if One OR = 1.68 or Two OR = 2.26 comorbid conditions In particular Anxiety OR = 2.39 Depression OR = 1.75 Osteoarthritis OR = 1.85 Back

Aurelie Najm @AurelieRheumo( View Tweet )

Why do Rheumatologists shift to private practice? Are there gender based differences? A survey of 100+ European rheumatologists Female 🚺 rheumatologists: Leave hospital earlier At a lower hierarchical level Reasons for leaving: nightshifts unfair promotion decisions

Aurelie Najm @AurelieRheumo( View Tweet )

ICI-PMR irAEs are sometimes underestimated compared to inflamm arthritis, but why? ICI-IA and ICI-PMR look different, but at @HSpecialSurgery, steroid needs and disease impact for both are basically the same. Let’s not devalue either @lovetolearn27 #EULAR2025 POS1200 @RheumNow https://t.co/NVq2tpjvdu

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David Liew @drdavidliew( View Tweet )
Depression and anxiety in PsA is higher and has more consequences than in general population Swedish and Danish clinical registers 23000+ PsA pts HR 1.4 specialised psychiatric out/ inpatient care vs. general pop HR for psychiatric in patient care numerically higher but ns. No https://t.co/qduMcwGK0S

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Aurelie Najm @AurelieRheumo( View Tweet )
#D2M_axSpA_saga 🇬🇷 Prevalence of D2M axSpA in 395 patients: 10.1% Associated factors: 🔹️High disease activity at diagnosis 🔹️Comorbidities (high BMI, smoking, depression) 🔹️Unemployment Kougkas et al. POS#0121 #EULAR2025 @rheumnow https://t.co/vcPcTATTx5

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
#neuromodulation in #rheumatoid #arthritis What is it? 👇 Autonomic & immune system interaction Who seeks this Rx? desperate pts w pain No Rx left Interested in technology #EULAR2025 @RheumNow @eular_org #D2T #RA https://t.co/XWWFiUK6Em

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Janet Pope @Janetbirdope( View Tweet )
Even after having things laid out in a great debate, rheumatologists remain unconvinced by medical cannabis #EULAR2025 @RheumNow https://t.co/xMTvngS5N1

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David Liew @drdavidliew( View Tweet )
Transcranial Stimulation is Effective in Fibromyalgia A randomized, controlled clinical trial in fibromyalgia (FM) has shown the efficacy of transcranial direct current stimulation (A-tDCS) (along with exercise and pain neuroscience education [PNE]), in alleviating the pain. https://t.co/P8SKs3JNEx
Dr. John Cush @RheumNow( View Tweet )
We should address patients anxiety at RA diagnosis: cohort 250+ newly diagnosed RA pts -49% reported anxiety -41% by 3 months Anxiety asso w/ CDAI, PROs and 3-5 fold increase in prescription of bio/tsDMARDs Analysis reasonably adjusted POS0163 #EULAR2025 @RheumNow https://t.co/2gejEkRQhO

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Aurelie Najm @AurelieRheumo( View Tweet )
Access inequity across Europe is real. New #RheumaFacts data show major gaps in RMD care: 🔹 Full tsDMARD access in just 4% of countries 🔹 Self-referral possible in 57% 🔹 Rheum physio reimbursed in 63% 🔹 Psych care? Only 30%. Abstract#OP0025 @RheumNow #EULAR2025

Jiha Lee @JihaRheum( View Tweet )

In #InflammatoryArthritis, baseline depression was linked to ↑ presenteeism & ↓ QoL at baseline + 3mo, but not absenteeism. Data from 9-country study provide further evidence that mental health is key to supporting work outcomes in RA, PsA & axSpA. @RheumNow #EULAR2025 #OP0028

Mrinalini Dey @DrMiniDey( View Tweet )

Systematic review of fibromyalgia & sleep quality - 47 RCTs, 11094 pts showed CBT for insomnia had a significant improvement in sleep quality; but CBT for pain had no impact. Only moderate improvement w/ pregabalin, sodium oxybate; but no effect w/ amitriptyline, milnacipran, https://t.co/bArizMLGR8
Dr. John Cush @RheumNow( View Tweet )
Systematic review of fibromyalgia & sleep quality - 47 RCTs, 11094 pts showed CBT for insomnia had a significant improvement in sleep quality; but CBT for pain had no impact. Only moderate improvement w/ pregabalin, sodium oxybate; but no effect w/ amitriptyline, milnacipran, https://t.co/AEqbShRh6e
Dr. John Cush @RheumNow( View Tweet )
Psychological Bulletin has published that invalidating (gaslighting) pts Sxs can have harmful consequences. Includes pts dx w/ Ehlers-Danlos, endometriosis, fibromyalgia, ME/CFS, POTS, Gulf War, IBS, long Covid, multiple chemical sensitivity, SLE, and vulvodynia.

Dr. John Cush @RheumNow( View Tweet )

Review of Emerging Treatments for Vitiligo an immune mediated dz that affects QOL & has psychosocial impact. JAKi only ruxolitinib is FDA-approved, but Tofa & Bari show promise. Emerging therapies include simvastatin, afamelanotide, and metformin https://t.co/Rp2yYx6SyZ https://t.co/pBo1IDe8pQ

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Dr. John Cush @RheumNow( View Tweet )
Psychological Bulletin has published that invalidating (gaslighting) pts Sxs can have harmful consequences. Includes pts dx w/ Ehlers-Danlos, endometriosis, fibromyalgia, ME/CFS, POTS, Gulf War, IBS, long Covid, multiple chemical sensitivity, SLE, and vulvodynia.

Dr. John Cush @RheumNow( View Tweet )

How Living With Childhood-Onset Lupus Impacts Mental Health Children, teens, and young adults with childhood-onset systemic lupus erythematosus (cSLE) require intense immunosuppressive treatments to prevent organ damage. Recently, the mental health burden for cSLE patients has https://t.co/JXkdYiAO9o
Dr. John Cush @RheumNow( View Tweet )
Diagnosing Neuropsychiatric SLE (5.23.2025) Dr. Jack Cush reviews the news and journal reports from RheumNow - including views on the vagus nerve, NPSLE and CAR-T mania. https://t.co/PadauvfWWA https://t.co/4k4nfHSPg5

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Dr. John Cush @RheumNow( View Tweet )
teen under covers looking anxious

How Living With Childhood-Onset Lupus Impacts Mental Health

Kaveh Ardalan, MD

Children, teens, and young adults living with childhood-onset systemic lupus erythematosus (cSLE) require intense immunosuppressive treatments to prevent serious organ damage. By the mid-2010’s, multiple studies were published that showed high rates of depression, anxiety, and suicidal

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“Courage is what it takes to stand up and speak; courage is also what it takes to sit down and listen.” – Winston Churchill https://t.co/5YMQppiMSG
Dr. John Cush @RheumNow( View Tweet )
Unmet needs in #lupus are many 👇 Timely #diagnosis Morbidity - CV, metabolic, OP, mental health Premature mortality - CAD, active #SLE, infection Issues w pregnancy #steroid side effects ⬇️QoL With partnerships we can ✅ Pts HCPs researchers Pharma Gov’t #LUPUS2025 @RheumNow https://t.co/9T9rIrM1hV

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Janet Pope @Janetbirdope( View Tweet )
Impt predictors of #neuropsychiatric #SLE #LUPUS2025 @RheumNow No major predictors But if explanation of other conditions ex Past #cvA #ischemic events Doesn’t have to have ➡️Active systemic ##Lupus ➡️ ?ribosomalP +Abs described in #CNS lupus A real headache! https://t.co/iuWfB454EN

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Janet Pope @Janetbirdope( View Tweet )
‘It’s #Lupus, it’s all in your head!’ ➡️ Some patients with #SLE have heard this from others At #LUPUS2025 in a packed session on #CNS lupus #Dx is tricky 40% of #neuropsychiatric lupus have NEGATIVE #brain #MRI 👇r/o infarct/bleed Infection Rx #steroids @RheumNow https://t.co/yU1olg0uZU

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Janet Pope @Janetbirdope( View Tweet )

Recent Blogs

Choice Overload (and the Way Out)

Jack Cush, MD
paint,choice,overload,color
I recently overheard a very good practicing rheumatologist complain, “why do I need yet another drug for psoriatic arthritis? I have more treatment choices than I have actual PsA patients who need a new or better drug”. Read Post

Comorbidities in RA: Focus on Difficult-to-Treat Disease

Elena Nikiphorou, MD, PhD
Puzzle pieces
The presence of comorbidities naturally complicates treatment choice, patient adherence to medication and patient outcomes, increasing also the risk of making RA ‘difficult-to-treat’. Read Post
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