Prevalence and Risk Factors of Depression in Patients With Endemic Osteoarthritis Kashin-Beck Disease

Background: Kashin-Beck disease (KBD) is an endemic osteoarthropathy, which occurs in children aged 3-12, with similarity to osteoarthritis (OA). Previous studies have shown significant depression symptoms in OA patients, yet no comparable research has been conducted in KBD patients. Methods: We conducted a field investigation in KBD areas in Northwest China. Questionnaires were designed and used to assess demographic characteristics, clinical characteristics, and medical comorbidities. Patient Health Questionnaire-9 (PHQ-9) was included for the prevalence of depression. Finally, 440 subjects were clinically diagnosed and recruited. Depression was diagnosed when PHQ-9 ≥ 5 and classified into mild (5-9), moderate (10-14), and severe (≥ 15) groups. Logistic regression was also used to identify potential associated factors among KBD patients. Results: Depression was present in 53.2% of patients in our KBD samples. Among them, 27.5% had mild depression, 18.4% had moderate depression, and 7.3% had severe depression. Being male (odds ratio [OR]: 0.296, 95% confidence interval [CI]: 0.180-0.486, p < 0.001) was an independent protective factor for depression, while the presence of comorbid chronic diseases (OR: 4.701, 95% CI: 2.292-9.640, p < 0.001), and a higher visual analog scale (VAS) pain level (OR: 5.275, 95% CI: 1.326-20.978, p=0.018) were independent risk factors for depression in KBD patients. Conclusion: This study is the first to investigate the prevalence of depression and associated factors among Chinese KBD patients, suggesting the significance of an early intervention for their mental issues.