Patient self-reported instruments for assessing symptoms in rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic joint autoimmune disease with a higher prevalence of depressive symptoms due to the burden of the disease. There are several patient-self-depression scales used for the assessment and a wide range of variations in the prevalence of depression could be related to this. No evidence was found that reports the most accurate, sensitive, and specific depression instrument through an extensive review in the literature. To determine the most precise depression instrument to evaluate RA patients. A systematic review search was directed, considering type of study, prevalence of depressive symptoms, usage of validated depression scales, and reported scale performance measurements. The data extraction followed the PRISMA guidelines, and the risk of bias was assessed using RoB 2, ROBINS-I, and QUADAS-2. From a total of 1958, only 28 articles included in the analysis. The total number of patients analyzed was 6405, with a mean age of 56.53 years, 4474 women (75.22%), and a mean prevalence of depressive symptoms of 27.4%. The most frequent and the best scale used was the CES-D (n = 12), considering all characteristics. The CES-D reported the best psychometric properties, and it was the most frequently used tool.