Depression in rheumatoid arthritis patients: demographic, clinical, and psychological predictors

Objective: To confirm the prevalence of depression in a sample of rheumatoid arthritis (R-A) patients; to identify the most significant predictors of depression in RA and to explore patients attitudes to medication in relation to depression. Methods: A cross-sectional survey was used to collect data from 134 RA patients (77% female, 23% male). Participants were divided into depressed and nondepressed groups based on their scores on the Center for Epidemiological studies-Depression (CES-D) scale. Discriminant analysis was conducted to identify, the predictors that would best categorise patients into those two groups. Results: Twelve predictors correctly classified 80% of patients into depressed or nondepressed groups. The strongest predictors of depression were high tension and low self-esteem followed by the perceived impact of RA, fatigue, passive coping, pain, and physical disability. Other predictors included medication effectiveness and importance as well as perceived lack of control over pain. Conclusion: Both physical and psychological factors have an impact on depression in RA. The key predictors identified in this study need to be considered within the regular RA management as possible cues to depression development. (c) 2006 Elsevier Inc. All rights reserved.