Frequency and Factors Associated with Depression in Rheumatoid Arthritis in African Black Patients: Case-Control Study

Abstract

Objective: To study the frequency and factors associated with depression in rheumatoid arthritis (RA) among Black African patients. Patients and methods: It was a case-control study with a group of patients with RA (case) and a group of healthy subjects without rheumatoid arthritis (con-trols) matched by age and sex. All patients admitted to the rheumatologic department during February 2015 to July 2015 for rheumatoid arthritis meeting the criteria ACR/EULAR 2010, were included. Patients with high blood pressure, diabetes mellitus, renal failure or HIV infection have been excluded. Depression was assessed by the Hamilton Rating Scale for Depression. Results: Fifty patients with RA were included and compared to 100 healthy controls. For RA patients, it was 39 (78%) female and 11 (22%) male with a sex ratio of 0.28. In the control group, it was 77 (77%) female and 23 (23%) male with a sex ratio of 0.29. Twenty-seven (54%) patients with RA had depression compared with 17 (17%) subjects in the control group (p = 0.000). Impaired quality of life and a DAS 28 score greater than 3.2 were statistically associated with depression during RA with a p value respectively of 0.021 and 0.0000231. Conclusion: Depres-sion is significantly more common during RA than in non-RA controls. RA patients should be screened routinely for depression in order to ensure improved treatment and management.