Interrelationship Between Depression and Disease Activity in Rheumatoid Arthritis: A Systematic Review and...

Area of Science:

• Rheumatology
• Psychiatry
• Epidemiology

Background:

• Rheumatoid arthritis (RA) is a chronic autoimmune disease with significant global prevalence, disproportionately affecting women.
• Depression is a common comorbidity in RA, exacerbating pain and disease severity.
• Understanding the prevalence and impact of depression in RA is crucial for effective patient management.

Purpose of the Study:

• To systematically analyze the prevalence rates of depression among RA patients.
• To identify risk factors and the effects of depression on RA disease activity and quality of life.
• To establish knowledge gaps for improved comprehensive management of RA patients with depression.

Main Methods:

• A systematic review and meta-analysis adhering to PRISMA guidelines.
• Inclusion of 19 cross-sectional studies from 2015-2025, analyzing adult RA patients assessed for depression.
• Data analysis using SPSS v26.0 with meta-analysis for pooled prevalence and heterogeneity assessment (I2 statistic, Cochran's Q test).

Main Results:

• The pooled prevalence of depression among RA patients was 39.31%, with significant heterogeneity (I2 = 96.9%).
• Higher prevalence rates were noted in Middle Eastern and South Asian populations.
• Depression correlated with increased disease activity, fatigue, pain, lower quality of life, and treatment non-adherence.

Conclusions:

• Depression is a highly prevalent comorbidity in RA patients, necessitating routine screening and management.
• Significant heterogeneity indicates variations in diagnostic tools, populations, and regional contexts.
• Further research is recommended to explore the bidirectional relationship between RA and depression.