Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Rheumatoid arthritis (RA) and depression is closely associated with each other. The serum level of neurotrophic factors are related with the major depressive disorder (MDD). However, the impacts of disease activity, pro-inflammatory cytokines and neurotrophic factors on depression in RA patients have not well studied. The aims of this study were to determine the risk factors for depression and to examine the effect of disease activity, pro-inflammatory cytokines and neurotrophic factors on depression in patients with RA.
Methods: This cross sectional study was conducted from Jan, 2014 to Jan, 2015 from 3 university hospitals. Demographic and laboratory data were examined and routine assessment of patient index data 3 (RAPID 3) questionnaire and 28 joints disease activity score (DAS28-CRP) were assessed for disease activity. Depression was measured by Korean version of the Beck Depression Inventory second edition (K-BDI II). Serum level of pro-inflammatory cytokines and neurotrophic factors such as BDNF, VEGF, GDNF, and IGF-1 were assessed by ELISA.
Results: A total of 507 RA patients were recruited. The prevalence of depression was 33.1% (n=168). RAPID 3 score (OR 1.2, 95% CI 1.1-1.4, P=0.006) and severity of fatigue (OR 1.19, 95%CI 1.07-1.32, P=0.001) showed significant associations with depression in multivariate analysis. The RA patients with DAS 28-CRP ≥3.2 (n=126) had more risk for depression than those with DAS 28-CRP<3.2 (n=279) in multivariate analysis (OR 2.02 95% CI 1.34-3.06, p=0.006). When patients was followed up for a year after strict treatment, as DAS28-CRP decreased, BDI score also decreased (ΔDAS28-CRP: -1.4±1.6, and ΔK-BDI II: -5.4±10.1, P<0.001). There were no relationships between pro-inflammatory cytokines and depression (IL-1β: r=0.057, IL-6: r=0.169, TNF-α: r=-0.078). In the case of neurotrophic factors, only the level of BDNF showed weakly correlation with K-BDI II score (r=-0.233, P<0.001).
Conclusion: This study suggests strict control of fatigue and disease activity is important in regulating depressive symptoms in patients with RA. To evaluate psychological manifestation of RA patients, using both RAPID 3 score and DAS28 might be helpful. Larger studies of the possible role of BDNF should be conducted.
To cite this abstract in AMA style:Suh YS, Cheon YH, Kim HO, Lim HS, Noh HS, Kim SH, Kim JM, Son CN, Lee SG, Park EK, Lee SI. Impacts of Disease Activity and Serum Level of Neurotrophic Factors on Depression in Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/impacts-of-disease-activity-and-serum-level-of-neurotrophic-factors-on-depression-in-rheumatoid-arthritis/. Accessed November 25, 2020.
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