From breakinglatest.news
Mood disorders, including anxiety and depression, are often associated with inflammatory rheumatologic diseases, particularly rheumatoid arthritis and spondyloarthritis
I have suffered from arthritis for years and now also from depression. I have changed several therapies, but without definitively resolving the mood disorder which has a strong impact on my life and perhaps also on the pain. What can I do?
Answers Charles Selmi
Head of Rheumatology and Clinical Immunology, Humanitas Institute, Milan (VAI AL FORUM):
Mood and anxiety disorders, especially depression, are the condition most frequently associated with inflammatory rheumatologic diseases, especially rheumatoid arthritis and spondyloarthritis including ankylosing spondylitis and psoriatic arthritis. From an immunological point of view, it is known that some mechanisms of inflammation are also at the basis of depression and anxiety and above all that the presence of these disorders worsens chronic pain, often increasing the need for symptomatic therapy.
The severity of depression and anxiety does not depend on the severity of the arthritis, although better control of rheumatologic disease also leads to improved mood. A recent study presented at the annual congress of the European society of rheumatology EULAR, held in Milan at the beginning of June 2023, demonstrated that out of over 42,000 patients with arthritis, 34% of those with ankylosing spondylitis and 22% of those with rheumatoid arthritis, suffered from anxiety while 27% and 19%, respectively, suffered from depression. The same study demonstrated that the presence of anxiety or depression is associated with a worse control of the rheumatological disease also due to a lower adherence to the prescribed therapy and therefore to less regular use of prescribed medications.
The management of anxiety and depression is often unsatisfactory and the results of this study demonstrate that it is necessary to recognize these conditions to improve the management of rheumatological diseases. It is also necessary to remember that some therapies, especially in the case of psoriatic arthritis, must be used with caution or avoided in those suffering from depression because they could cause it to worsen.
Rheumatoid arthritis and spondylarthritis represent systemic diseases that are associated with a high risk of other conditions, both metabolic and psychiatric, and in the case of the presence of depression or anxiety in arthritis sufferers, a combined management between rheumatologist and psychiatrist is certainly desirable for better control of both diseases and to improve the quality of life.
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