DEPRESSION IN RHEUMATOID ARTHRITIS PATIENTS ITS IMPACT ON DISEASE ACTIVITY AND QUALITY OF LIFE

Abstract

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disorder that primarily affects joints, leading to pain, swelling, and potential joint destruction. Beyond its physical symptoms, RA is associated with psychological issues, particularly depression, which can exacerbate the condition and complicate treatment. The prevalence of depression in RA patients is significantly higher than in the general population, making it a crucial area for further investigation and intervention.

Objective: The primary objective of this study was to quantify the prevalence of depression among RA patients and evaluate its effect on disease activity and quality of life.

Methods: This prospective cohort study was conducted at Lady Reading Hospital, Peshawar, from April 2023 to March 2024. The study included 303 patients diagnosed with RA, aged 18 years or older, with documented treatment for at least one year. Depression was assessed using the Hospital Anxiety and Depression Scale (HADS-D), disease activity was measured using the Disease Activity Score in 28 joints (DAS28), and quality of life was evaluated using the SF-36 Health Survey. Descriptive statistics, t-tests, chi-square tests, and logistic regression analysis were employed to analyze the data.

Results: The study found that 48.5% of the 303 RA patients exhibited depressive symptoms, with a mean HADS-D score of 10.3 (SD 4.2). Patients with depression had significantly higher DAS28 scores (mean 5.1, SD 1.4) compared to those without depression (mean 4.3, SD 1.2; p<0.001), indicating more severe disease activity. Additionally, depressed patients reported lower quality of life scores across all SF-36 domains. Logistic regression analysis identified higher DAS28 scores and lower SF-36 scores as significant predictors of depression in RA patients.

Conclusion: The findings highlight the high prevalence of depression among RA patients and its adverse effects on disease activity and quality of life. Integrating routine mental health screening and psychological support into standard RA treatment protocols is essential to improve patient outcomes. Future research should explore the efficacy of integrated care models and longitudinal studies to establish causal relationships and long-term effects of depression management on RA outcomes.