Anxiety is More Common in Arthritis Patients Than Depression

  • A new study published in Arthritis Care & Research suggests that one third of US adults living with doctor-diagnosed arthritis (including rheumatoid arthritis, gout, lupus, fibromyalgia, or some other form of arthritis) aged 45 or older report having anxiety, depression, or both.  The study comprised a phone survey of 1,793 individuals living with arthritis from the Arthritis Condition and Health Effects Survey (ACHES) which is the most comprehensive population-based national survey of US adults with arthritis to date.

    Eighteen percent of respondents reported having depression, a common comorbidity in patients living with chronic illnesses including rheumatoid arthritis (Murphy, 2012). In previous studies involving RA patients, nearly 20% of patients experienced depression (Söderlin, 2000).  Whether we’re talking about arthritis, rheumatoid arthritis or rheumatic diseases, it seems that rates of depression have remained similar over time.

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    In the current study, almost twice as many people living with arthritis experienced anxiety (30.5%) as compared to depression (17.5%).  Eighty-four percent of respondents with depression also reported anxiety.  Thus a significant portion of patients (14.7%) living with arthritis experience both depression and anxiety.

    Have you ever experienced depression or anxiety, or both, and do you live with a rheumatic disease?

    I have and I do.  In fact just recently, I wrote about experiencing increased anxiety in the face of a very busy and stressful time.  It is the one symptom which I reported as being “off the charts” when I had my 4-month visit with my nurse practitioner at the neurology clinic.  We decided to adjust my therapies.

    I have been on antidepressants for the better part of 20 years.  Only during extraordinary times have I used anti-anxiety medications, or during those times when I’ve received 1000mg of intravenous steroids daily for an MS relapse.  My nurse prescribed a low dose of alprazolam (Xanax) and gave me “permission” to use it.  Even using it sparingly, I have noticed a difference.

    Although I frequently discuss depression or anxiety with my doctor or nurse in the neurology office, I haven’t really discussed mental health issues with my rheumatologist.  With MS, symptoms of depression and anxiety can be symptoms of the disease itself, not just a response to the disease.  I’ve just not really thought about MY depression as being caused by rheumatoid arthritis.

    Have you discussed depression or anxiety with your rheumatologist?

    About half of the respondents in the current survey who are being treated by a health care professional for their arthritis had not sought treatment for their depression and/or anxiety in the past year.  Murphy et al. suggest “there is an unmet need for treatment of mental health conditions among people with arthritis” and that visits with a health care professional “for management of arthritis symptoms may be an opportunity to screen for and treat anxiety and depression.”

  • A combination of clinical and self-management interventions would be ideal in the treatment and management of anxiety and depression.  Inexpensive and convenient interventions, such as aerobic exercise and self-management programs, have been shown effective in helping to reduce anxiety and depression (Conn, 2010; Brady, 2009).  Patients are 18.5 times more likely to attend a self-management class if their health professional recommends one (Murphy, 2007).

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    No distinct profiles emerged from analyzing subgroups of patients with arthritis who experience anxiety and/or depression.  Thus Murphy et al. suggest that all people with arthritis should be systematically screened for both conditions.

    If you are experiencing anxiety and/or depression, please mention it to your doctor, nurse, therapist, or friend.  Help is available and you do not need to suffer in silence.

    Murphy LB, Sacks JJ, et al. Anxiety is more common than depression among US adults with arthritis. Arthritis Care and Research; Published Online: April 30, 2012 (DOI 10.1002/acr.21685)

    Söderlin MK, Hakala M, Nieminen P. Anxiety and depression in a community-based rheumatoid arthritis population. Scand J Rheumatol. 2000;29(3):177-83.

    Brady TJ, Jernick SL, Hootman JM, Sniezek JE. Public health interventions for arthritis: expanding the toolbox of evidence-based interventions. J Womens Health (Larchmt). 2009;18(12):1905-17.

    Conn VS. Anxiety outcomes after physical activity interventions: meta-analysis findings. Nursing research. 2010;59(3):224-31.

    Murphy LB, Theis K, Brady TJ, et al. A health care provider's recommendation is the most influential factor in taking an arthritis self-management course: A national perspective from the Arthritis Conditions and Health Effects Survey. Arthritis and Rheumatism. 2007;56(9):S307-S8.


    Lisa Emrich is author of the blog Brass and Ivory: Life with MS and RA and founder of the Carnival of MS Bloggers.

Published On: May 01, 2012