Background/Purpose: Depression has been shown to be more common in patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA), than in the general population. The extent of this disease has not been studied in comparison between patients with PsA and those with RA. We studied the prevalence of depression in patients with PsA in comparison to those with RA.

Methods: A retrospective observational study was done using data collected from a community-based rheumatology clinic. All patients with data on depression were included for analysis. Baseline demographics, tender joint count (TJC), swollen joint count (SJC), Physician Global Assessment (PhGA), Pain Scale, Patient Global Assessment (PtGA), Function, Routine Assessment of Patient Index Data 3 (RAPID3) (a composite score of patient pain, PtGA, and Function), and Clinical Disease Activity Index (CDAI) (a composite score of TJC, SJC, PtGA, and PhGA) were collected. A validated depression scale was used to assess depressed mood. Data from random visits were chosen and analyzed using an ordered logistical regression. Both a univariate analysis and an analysis controlling for potential confounding variables were performed, using either CDAI or RAPID3 as the marker for disease activity.

Results: The study population consisted of 146 patients who had PsA and 366 who had RA. On a 0-3 scale for depressed mood, patients with PsA reported a mean of 0.55 ± 0.73, whereas patients with RA reported a mean of 0.40 ± 0.64 (Table 1). When assessing the data using an ordered logistical regression, patients with PsA were 57% (p=0.02) more likely to report a higher level of depression than those with RA. When adjusted for disease activity using the CDAI and the RAPID3, the likelihood of PsA having a higher level of depression was 78% (p=0.01) and 58% (p=0.04) compared to RA, respectively. Lastly, a T-test was performed revealing a statistically significant difference between the PsA and RA groups (p<0.02).

Conclusion: In this cohort, patients with PsA were more likely to report higher levels of depression than those with RA. Furthermore, this occurred independently from levels of disease activity as measured by either the CDAI or the RAPID3. Although causality is yet to be determined, this study enforces the importance of depression screening in rheumatology practice, and early treatment.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/depression-has-a-greater-impact-on-psoriatic-arthritis-than-rheumatoid-arthritis/