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Mental Health

Joint hypermobility linked to depression & anxiety? Longitudinal Study of 6105 kids at age 14 yrs: 19% had generalised joint hypermobility (more in F) *+& assoc w/ depression (OR: 3.53), anxiety (3.14) at age 18
We know depression, anxiety are issues for many RA pts. Are we making the diagnosis more? Olmsted County data: depression similar over time anxiety 3x more common in 2005-2014 vs 1985-1994 (adj age/sex +/- others) How do we address this? ABST0886 @MayoClinic #ACR22 @RheumNow

Are we really treating Psoriatic disease if we only address active disease domains and T2T?

Nov 12, 2022

It’s widely accepted that Psoriatic disease has multi-system, multi-domain potential that can lead to life altering complications if left untreated or undertreated. Rheumatologists have shifted the way we discuss treatment options and disease state expectations with patients. Two #ACR22

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Metanalyses have shown polypharmacy incr risk of dementia. New Wales study of 33,451 dx'd dementia pts. Freq of polypharmacy (3+ meds) grew over 20 yrs before DDx - from 5.5%, to 41%, to 70%, and 82% just before dx of Dementia.

Physician Burnout Rising

Oct 06, 2022

The NY Times has reported results of a study showing that nearly two-thirds of doctors are experiencing at least one symptom of burnout, with a marked increase since the onset of the pandemic.  These findings suggest that burnout rates amongst US doctors have risen to alarming levels.

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Heavy Metal Rheumatology (9.23.2022)

Sep 23, 2022

Below are this week’s highlights from RheumNow, as discussed by Dr. Jack Cush. Thanks to all of you for your kind comments and great reviews of our weekly podcast. Please let us know how we can improve by emailing me or recording your suggestion using the "Ask Cush Anything" link on our website

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USPSTF Recommends Screening for Anxiety and Depression

Sep 22, 2022

The U.S. Preventive Services Task Force has recommended that general practitioners actively screen and identify anxiety and depression in all adult patients under 65 yrs.

The USPSTF was appointed by the Department of Health and Human Services, and has been working on this guideline

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Melatonin Use Growing, Inappropriate & Potentially Unsafe

Aug 18, 2022

With nearly one-third of adults, adolescents and children having sleep difficulties, many resort to using melatonin. JAMA reports substantial increases in the use of over-the-counter (OTC) melatonin, in all age groups. But is it effective, safe and warranted?

The National Health

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Hit Parade Review (8.12.2022)

Aug 12, 2022

We've got a lot to discuss this week: psoriasis; fatigue; sleep; sural nerve biopsies; uveitis and SpA; diet and RA; tofacitinib and the ORAL surveillance study; what not to take with mycophenolate - and more. In what order should these items be discussed? This week the run down is based on

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Watch: Major Consequences of Depression In RA
RA & dementia - it's getting more damning RA dementia risk: HR 1.25 from Korean nationwide data: RA n=138,592 this follows @MyasoedovaElena's data RA systemic inflamm leading to dementia (AD, vascular)? Need to understand if any DMARD protective OP0271 #EULAR2022 @RheumNow
#EULAR2022 OP0067: Depression is a major risk factor (6X!) for mortality in RA. Study may show some bias in the methods, but critical findings for all rheumatologists to consider @RheumNow
Watch: EULAR 2022 - Day 1 Faculty Recap Pane Drs. Jack Cush, Eric Dein and Kathryn Dao discuss highlights from day 1 at #EULAR2022 - Guidelines, Lupus, and more.
Comorbidity in AS from @rheum_cat , Karmacharya et al. Clustering of comorbidities. Depression and hypertension clusters assoc worse disease activity and function @RheumNow #EULAR2022 OP0154
#EULAR2022 OP0134: Active RA increases risk of dementia Olmsted County, MINN studying RA risk factors for dementia: ⭐️886 pts incident RA, mean age 65. 103 develop dementia Risk factors: Age, rheum nodules, large jt swelling, depression/anxiety, HTN, CVD events @Rheumnow
Dementia in RA associated w/ ⚡️Large joint swelling HR 2 ⚡️Any CVD HR 2.25 ⚡️Anxiety HR 1.86 ⚡️Depression HR 2.63 at any time during disease course in retrospective cohort 800+ pts #EULAR2022 @RheumNow OP0134 @MyasoedovaElena
🚨 Depression = major comorbidity! DANBIO register 10000+ patients: ❗️10% prescription antidepressants💊 ❗️Cumulative mortality ⬆️ w/ OR>6 ❗️Particularly in age group <55 #OP0067 #EULAR2022 @RheumNow
Screen for depression in RA patients! From the #DANBIO registry of 11,000 pts, they found 6X ⬆️mortality in pts w/#RA and #depression . The mortality curve separates early. #Plenary OP0067 @rheumnow #EULAR2022

Is Gout Protective Against Dementia?

MedPage Today
May 25, 2022

People with gout appeared less likely to develop dementia than age- and sex-matched peers, a database study from Korea found.

The analysis of more than 5,000 gout patients and 25,000 controls in Korea's national healthcare system yielded adjusted hazard ratios of 0.79 for overall new-

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Long COVID Manifestations

May 24, 2022

The acute consequences of a SARS-CoV-2 infection may be bothersome or devastating, but the long-term consequences may lead to so-called "long COVID" syndrome.  Long COVID appears to affect up to 20% of those who survive COVID-19 infection. 

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Expansive (full read) review of CBD - legal and regulatory overview, availability, physiologic and pharmacologic effects, safety, & risks, standards, use in specific rheumatic disorders.
Depression was studied in 208 #PSA patients - Depression was found in 30%. Depression risk was higher in those with higher disease activity (DAPSA; P=.007) and functional impairment (HAQ-DI; p=-.02)

RheumNow Podcast – What You Do For & What You Do To the Patient (4.8.2022)

Apr 08, 2022

Dr. Jack Cush reviews the news and journal articles from the past week and discusses the use of fibroscan in RA, steroid hip injections in OA and famous quotes from a famous cardiologist.

  1. CorEvitas Registry study of173 Axial #PsA pts showed 6 mos of bDMARD/tsDMARD resulted

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PsA All the Way – Unmet Needs

Apr 01, 2022

Throughout the month of April 2022, RheumNow is introducing a new approach to education and information sharing – a campaign devoted to a single disease. Our first campaign is entitled PsA All the Way: RheumNow will escalate awareness on this topic, its unmet needs, clarify advances and discuss

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Do you discuss/screen for depression with your patients when discussing pain and fatigue? #RNL2022 @RheumNow