Screening for Anxiety, Depression, and Fibromyalgia in Routine Care of All Rheumatic Diagnoses on a Multidimensional...

Area of Science:

• Rheumatology
• Psychosomatic Medicine
• Clinical Assessment

Background:

• Routine care in rheumatology involves diverse patient populations with various rheumatic diagnoses.
• Assessing mental health comorbidities like anxiety and depression is crucial in managing rheumatic diseases.
• Fibromyalgia screening is also important due to its overlap with other rheumatic conditions.

Purpose of the Study:

• To determine the prevalence of positive anxiety, depression, and fibromyalgia screening in unselected rheumatology patients.
• To compare pain levels and disease activity (using RAPID3) between patients with positive and negative mental health screens.
• To evaluate the utility of a single multidimensional health assessment questionnaire (MDHAQ) for comprehensive screening.

Main Methods:

• Utilized the MDHAQ for screening anxiety, depression, and fibromyalgia in 1,337 rheumatology patients across 15 diagnoses.
• Calculated frequencies of positive screens for each condition and any of the three.
• Compared median pain scores (VNS) and RAPID3 scores between patients with positive versus negative screening results.

Main Results:

• 44% of patients screened positive for anxiety, depression, and/or fibromyalgia.
• Positive screening rates varied by rheumatic diagnosis category (17%-39% anxiety, 9%-33% depression, 7%-31% fibromyalgia).
• Patients with positive screens reported significantly higher median pain (7.0/10 vs 4.0/10) and RAPID3 scores (17.0/30 vs 8.2/30) compared to those with negative screens (p<0.001).

Conclusions:

• A significant proportion of rheumatology patients exhibit positive anxiety, depression, or fibromyalgia screening.
• These positive screens correlate with substantially increased pain and disease activity.
• Integrating pragmatic screening into routine rheumatology encounters is recommended for improved clinical decision-making.