Anxiety and depression in patients with osteoarthritis: impact and management challenges

Abstract

BackgroundAnxiety and depression are common psychological comorbidities that impact the quality of life (QoL) of patients. In this systematic review, we 1) determined the impact of anxiety and depression on outcomes in patients with osteoarthritis (OA) and 2) summarized unique challenges these comorbidities present to current OA management.Patients and methodsA systematic literature search was performed using the OVID Medline and EMBASE databases until April 2016. Full-text research articles published in English from the year 2000 onward with a sample size of >100 were included in this review. Eligible research articles were reviewed and the following data were extracted: study author(s), year of publication, study design, and key findings.ResultsA total of 38 studies were included in the present review. The present study found that both anxiety and/or depression were highly prevalent among patients with OA. Patients with OA diagnosed with these comorbidities experienced more pain, had frequent hospital visits, took more medication, and reported less optimal outcomes. Management strategies in the form of self-care, telephone support, audio/video education programs, and new pharmacotherapies were reported with favorable results.ConclusionAnxiety and depression adversely impact the QoL of patients with OA. Physicians/caregivers are highly recommended to consider these comorbidities in patients with OA. Ultimately, a holistic individualized management approach is necessary to improve patient outcomes.

Path model of factors influencing health‐related quality of life among older people with knee osteoarthritis

“…We found that depressive symptoms had a significantly adverse direct effect on quality of life. Our results were consistent with earlier evidence found in community‐based older adults with knee OA and rheumatoid arthritis (Mesci et al, ; Ozcetin et al, ; Sharma et al, ). Depressive symptoms had a strong negative correlation with quality of life, indicating a direct effect on poor quality of life.…”

“…Our findings emphasize the impact of knee OA on both physical and psychological aspects. The conundrums of fatigue on the participants in our study were similar to another study's results, which indicated that depressive symptoms were a comorbidity affecting quality of life in people with knee OA (Sharma, Kudesia, Shi, & Gandhi, ).…”

Association Between Knee Pain, Impaired Function, and Development of Depressive Symptoms

“…2 Knee OA can lead to restrictions in ADLs, [3][4][5] declines in quality of life, 6 and subsequent detriments to mental health. 7,8 The relationship between depression and knee OA has been gaining attention recently, with some recent studies showing associations between knee OA and development of depressive symptoms, 9,10 but most of these studies focused on radiographic changes rather than actual symptoms in their assessments of knee OA. Few have examined directly how knee pain and function relate to depressive symptom.…”

Atraumatic knee pain

“…This group is characterised by a higher pre-operative incidence of mental problems and catastrophising (18,19). Such studies underscore that the causal relationships in chronic knee pain can be complex and that the treatment needs to take this into account (Figure 1).…”