VIDEO: Links between RA, depression

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Depression is prevalent in the gender population but it's even more prevalent in people with rheumatoid arthritis. In some studies, the prevalence of depression in RA populations is 20%, in some cases even higher than that. So obviously that's pretty high. There's a lot of links between depression and RA. One is that frankly the disease is depressing to people. They have chronic pain in many cases, fatigue can be debilitating. They don't feel like their old normal self, so to speak. They've lost a lot of activities and abilities. They've had to give up a lot of things that they used to enjoy doing that might be athletics or might be participating in social activities with friends. And they may have lost their ability to work which is important. And so for all those reasons, it can be very psychologically challenging and frankly depressing to live with RA in some cases. Additionally, there is some crosstalk and when people develop depression they may actually exacerbate the inflammatory aspects of their disease and vice versa, the inflammation may actually feed directly into the brain chemistry that becomes altered and leads to manifestations of depressed mood. So it's literally bidirectional that we see factors in depression that exacerbate RA and we see factors with RA that bring out and worsen depression. Even in people who don't yet have RA, there is some relationship in some studies suggesting that depression may be a risk factor for a certain type of RA that is called seronegative RA. And we do not understand that relationship very well yet and it needs to be confirmed. But there has been that link positive as well. So a lot of links between depression and rheumatoid arthritis. For clinicians, I think it's important to be aware of that and to be sensitive to the possibility of depression, to look for it, to use the right questions or surveys to pick up depression in people that you're seeing in the clinic and then to treat it. And that may mean referring to psychiatry or other mental healthcare providers, or it may mean getting some skills at managing depression even in rheumatology or certainly in primary care. And I think that already happens very much in primary care probably less so in rheumatology. But many of us are beginning to think that might be important to consider in some situations, at least to be screening for it and recognizing it and referring when necessary. Because I think it's important to get it for getting the best outcomes for health in people with rheumatoid arthritis and probably also in achieving best outcomes of RA itself. So those are the links that we see between depression and RA.