TORONTO, Ontario, Canada—Rheumatologists should be on the lookout for depression and suicidal ideation among arthritis patients. A new Canadian study finds that 1 in 10 Canadians with arthritis are also depressed and that 1 in 5 individuals with arthritis and major depression had been suicidal in the past year. The findings appear in the July 15, 2009, issue of Arthritis Care & Research1.

“Our findings highlight the importance of better screening, improved outreach, and higher utilization of psychotherapeutic interventions and, when appropriate, antidepressant medication for patients with arthritis and major depression.”—Esme Fuller-Thomson, PhD
“Our findings highlight the importance of better screening, improved outreach, and higher utilization of psychotherapeutic interventions and, when appropriate, antidepressant medication for patients with arthritis and major depression,” conclude the study authors, who were led by Esme Fuller-Thomson, PhD, of the University of Toronto in Toronto, Ontario, Canada. “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.”

Are rheumatologists missing the signs of depression in RA?

In the new study, fully 1 in 10 Canadians with arthritis had clinically relevant levels of major depression as assessed by a subset of items from the Composite International Diagnostic Interview. Arthritis patients were about twice as likely to be depressed or have suicidal thoughts compared to their counterparts without arthritis, the study found. Particularly at risk were: women, the unmarried, younger, and poorer individuals.

Translating research into practice: Screen high-risk patients now

The study highlighted some high-risk subgroups. Patients with pain, limitations in activities of daily living, and those with greater numbers of chronic conditions had higher odds of major depression. Less than half of those with major depression had consulted a mental health professional, and just one-third of arthritis patients with depression were currently taking antidepressants.

“The majority of individuals with arthritis and major depression were not receiving adequate treatment for major depression,” the study authors write. “Clients should be screened for major depression and suicidal ideation, particularly if they fall into the identified vulnerable groups.”

Reference
1. Fuller-Thomson E, Shaked Y, Factors associated with depression and suicidal ideation among individuals with arthritis or rheumatism: findings from a representative community survey. Arthritis Care & Research. 2009;61:944-950.