Patients with rheumatoid arthritis (RA) are over three times more likely to die within a year of feeling symptoms of depression compared to people with RA who do not have depression. And this is particularly true for men.
In the study, men with RA who experienced feelings of worthlessness and emptiness, or were disengaged from activities they once enjoyed, were five times more likely to die within the next year than women with RA who did not have depression.
“Men are less likely to be proactive about seeking help, so it is important for men with RA to be aware of their feelings and be willing to discuss them with their doctor,” said study co-author Patricia Katz, Ph.D., professor of medicine and health policy at the University of California, San Francisco.
The researchers evaluated a group of 530 RA patients who were followed from 2002 or 2003 until 2009 or death. The mean age was 60, and 84 percent were women.
Through an annual telephone interview, all participants answered 15 questions from the Geriatric Depression Scale (GDS), which measures feelings of anxiety, fulfillment and/or hopelessness. If participants answered yes to at least five of the questions, they were considered to have significant levels of depressive symptoms.
This was not a formal diagnosis of depression, said Katz — just a red flag that the individual had symptoms associated with depression.
Participants with a GDS score of 5 or higher were 3.5 times more likely to die in the following year than those with lower scores. Also, those whose score worsened by 2 points or more from one year to the next were at least two times more likely to die within the following year than those whose score did not go up as much.
“A take-home message is that if you are having trouble performing activities that are important to you, perhaps you can find another way to do them,” said Katz.
“Physical or occupational therapy or a change in medication may help. If these strategies don’t work, try to find other activities that are rewarding to you to replace the ones you have lost.”
Although the link between depression and mortality is not new, this study reinforces the association between the two factors, said Amanda Nelson, MD, assistant professor of medicine at the University of North Carolina Thurston Arthritis Research Center, Chapel Hill.
“These findings suggest that patients with RA should be alert to their feelings of sadness and depression and be willing to discuss them with their health care practitioner,”said Katz.
The research was presented at the 2012 annual meeting of the American College of Rheumatology.
Source: American College of Rheumatology