FRI0077 THE PREVALENCE OF DEPRESSION AND ANXIETY IN PATIENTS WITH RHEUMATOID AND PSORIATIC ARTHRITIS AND ITS CONTRIBUTORY FACTORS
Authors: S. Selvadurai, L. Mohamed Nor, N. I. Redzuan, L. Mohd Isa, N. S. Shahril
Journal: Annals of the Rheumatic Diseases (2020)

Background: Rheumatoid Arthritis (RA) and Psoriatic arthritis (PsA) are both chronic, progressive inflammatory arthritis that can cause significant disability and morbidity. Depression in RA has been associated with higher levels of disease activity, pain, fatigue, work disability, lower treatment compliance and increased suicidal risk and mortality [1]. PsA patients suffer from psoriasis and joint involvement; hence have greater odds of depression by 2.1 times compared with RA [2]. Objectives: To compare the prevalence rates of depression and anxiety and its associated factors between RA and PsA patients in Hospital Putrajaya. Methods: A cross sectional survey using the Hospital Anxiety and Depression Scale (HADS) questionnaire were distributed to 300 patients who attended rheumatology outpatient clinic from February – April 2019. The HADS was categorized into 3 groups based on their scores 0-7 (Normal); 8-10 (Borderline); and 11-21 (Abnormal). Data on patient demographics and components of disease assessment scores were recorded. Disease activity was assessed using DAS 28-CRP for all patients. Additional evaluation using Bath Ankylosing Spondylitis Disease Activity Score (BASDAI) and body surface area (BSA) were done for PsA patients. P value of &lt; 0.05 was taken as significant. Results: In total, 205 RA and 73 PsA patients were eligible for analysis. Majority of the patients were female, Malay and married for both groups. The mean age group for RA and PsA were 56.2 ± 11.9 years and 51.0 ± 14.6 years. The mean duration of disease for RA were 8 ± 10 years; while for PsA were 6 ± 11 years. The prevalence rates of depression and anxiety for RA were 8.3% and 13.7%; and PsA were 9.6% and 17.8% respectively. Borderline scores for depression occurred in 16.1% of RA patients and 12.3% for PsA. Twenty percent of RA patients (n=41) and twenty-four percent of PsA patients (n=18) scored borderline for anxiety. The significant positive correlations with depression and anxiety in RA include high disease activity scores (r = 0.27; r = 0.31), number of tender joints (r = 0.26; r = 0.24) and pain (r = 0.29; r = 0.27). Higher number of swollen joints significantly correlated with depression (r = 0.16) but not with anxiety. RA patients with Ischaemic Heart Disease (IHD) ± heart failure have higher depression scores (p &lt; 0.05). As for PsA group, high BASDAI score (anxiety: r = 0.34, depression: r = 0.26) and psoriasis involving head and neck region (p &lt; 0.05) were significant associated factors. Age was inversely correlated with anxiety in the PsA group. Conclusion: There is higher prevalence of anxiety in both RA and PsA as compared to depression. Higher disease activity scores were associated with depression and anxiety in both RA and PsA with axial involvement. References: [1]Faith Matcham et al. “Are depression and anxiety associated with disease activity in rheumatoid arthritis? A prospective study” BMC Musculoskeletal Disorders (2016) 17:155. [2]Sinnathurai et al. “Comorbids in psoriatic arthritis and rheumatoid arthritis”. July 2018. Internal Medicine Journal.Available from https://doi.org/10.1111/imj.14046 [3]RA Rahim et al. “ Self-reported symptoms of depression, anxiety and stress among patients with Rheumatoid Arthritis in a Malaysian rheumatology centre – prevalence and correlates”. Med J Malaysia Vol 73 No 4 August 2018 Disclosure of Interests: None declared