Study of Depression among a Sample of Patients with Rheumatoid Arthritis in Baghdad, Iraq

Abstract

ABSTRACT
Background: Rheumatoid arthritis is a common chronic systemic autoimmune
inflammatory disease that affects mainly the synovium with multiple joints involvement and
with many systemic signs and symptoms the patients has pain and physical limitation that
affect their quality of life. It leads to chronic articular pain, disability and excess mortality.
Depression is a common sequel of rheumatoid arthritis and it is a mental illness
characterized by a profound and persistent feeling of sadness or despair and\or loss of
interest. Depression is important contributor to poor health outcome in rheumatoid arthritis
patients.
Objectives: To study the factors affecting depression among rheumatoid arthritis patients
in Al-Khadimiya teaching hospital.
Methods: Descriptive outpatient case-series study of 150 patients attended rheumatology
outpatient unit at Al Khadimiya Teaching Hospital, (63 males and 87 females) were
subjected to the ICD10 questionnaire - (major depression module) by direct interview.
Data were collected in period between the 1st of December 2012 and the 1st of May 2013.
Data were statistically analyzed by statistical package for socials sciences –version
(SPSS 20) was used for data input and analysis and by using Chi square test, Fisher
exact test and one way ANOVA test p value < 0.05 is considered significant.
Results: Current prevalence of major depression in rheumatoid arthritis patients was
found to be 34% (males 25.4%, females 40.2%). Statistically significant difference was
found between, age groups (≥ 60 years is risky), severity of disease presence of other
chronic disease occupation of the patients, education and marital status groups (being
widow, divorced or single is risky and presence of other chronic disease was also a risk
factor for developing depression. Logistic regression showed that risk factors for
developing major depression in rheumatoid arthritis patients were being widow, divorced
or single, as well as having severe form of RA, while being employed was a protective
factor against the development of major depression in same patients.
Conclusions: Among patients with rheumatoid arthritis it is found that current prevalence
of major depression is 34%, which is higher than other studies done elsewhere (13-20%).
Also, it was found that having the more severe form of rheumatoid arthritis, being a widow,
divorced or single, or being ≥ 60year old are risk factors to develop major depression in
rheumatoid arthritis patients, while being employed was a protective factor.