Depression in arthritis patients often untreated

People with arthritis seem to have an elevated rate of depression, but the disorder goes untreated more often than not, a new study suggests.

Researchers found that among more than 130,000 Canadians in a national health survey, those with arthritic conditions were more likely to suffer from symptoms of depression. Ten percent met the criteria for major depression, compared with roughly 7 percent of adults without arthritis.

When the researchers weighed other factors - like age, sex and socioeconomics - arthritis sufferers were twice as likely as others to have depression. They were also more likely to acknowledge having suicidal thoughts in the past year.

But while major depression was relatively common, it often went unaddressed. Fewer than half of adults with arthritis and depression said they had consulted a mental health professional, the researchers report in the journal Arthritis & Rheumatism.

The findings suggest that doctors should screen arthritis patients for signs of depression, write Dr. Esme Fuller-Thomson and Yael Shaked of the University of Toronto.

Their findings are based on survey data from 130,880 Canadian adults, more than 23,000 of whom said they had been diagnosed with arthritis or rheumatism - which refers to any painful condition affecting the joints and connective tissue, such as rheumatoid arthritis.

Based on a standard questionnaire used to diagnose depression, 10 percent of adults with arthritic conditions had the disorder. Women, as well as adults who were young, single or lower-income, were at relatively higher risk.

Three percent of arthritis sufferers said they had seriously contemplated suicide in the past year, compared with just over 2 percent of other adults. Again, younger and lower-income adults were at greater risk, as were men.

Arthritis sufferers' pain levels were also closely linked to their odds of depression, while physical limitations and disability were associated with suicidal behavior.

Depression screening, the researchers note, may be especially important for these higher-risk arthritis patients.

Improved arthritis knowledge might also help, Fuller-Thomson and Shaked point out. A previous study showed that arthritis patients who were more educated about their condition were less likely to suffer depression.

"In sum," the researchers write, "health care professionals play a key role in assisting individuals in developing coping strategies to deal with their depression in relation to their arthritic diagnosis and the daily stress induced by arthritis."

SOURCE: Arthritis & Rheumatism, July 15, 2009.