Associations of Rheumatoid Arthritis and Depressive Symptoms Over Time: Are There Differences by Education, Race/Ethnicity, and Gender?

Abstract

Objective. To examine associations between changes in rheumatoid arthritis (RA) symptoms and depressive symptoms adjusted for other time-varying characteristics, and to test if these associations differed by education, race/ethnicity, or gender.Methods. Data from the 1988-1998 US National Rheumatoid Arthritis Study were analyzed (n = 854). Time-varying covariates included year of the study, pain, functional ability, household work disability, parental status, marital status, employment status, and social support. The time-invariant covariates included years since diagnosis, education, race/ ethnicity, and gender. Multivariate multilevel-model analyses were used to estimate associations within people over time.Results. Patients with RA experience considerable change in depressive symptoms, pain, functional disability, and household work disability over the study period. Depressive symptoms were driven more by differences between people compared to changes within people over time. Findings show that patients experienced increases in depressive symptoms over the study period. The rate of change in depressive symptoms did not differ by education, race/ethnicity, or gender. Times of worse pain, functional disability, and household disability were associated with worse depressive symptoms. The association of functional disability and depressive symptoms was stronger for men than women.Conclusion. Increases in pain and disability were associated with worse depressive symptoms, adjusted for covariates. It is important to monitor and treat both mental and physical health symptoms. Future research efforts should focus on collecting data reflecting the educational, gender, and racial/ethnic diversity of individuals with RA.

Employment of patients with rheumatoid arthritis - a systematic review and meta-analysis

“…More women than men develop RA, however this study showed that a higher proportion of men managed to remain employed compared to women [18,36,42,43,46,62,71,89,101,116]. Previous studies have shown inconsistent results in this regard.…”

“…Higher educational levels were associated with a greater possibility of employment [30,43,45,46,51,62,86]. This is probably due to enhanced job opportunities, flexibility, lower physical workload, better insurance coverage, and improved health care for well-educated individuals.…”

Associations of gender with sexual functioning, loneliness, depression, fatigue and physical function amongst patients suffering from rheumatoid arthritis with a particular focus on methotrexate usage

“…The higher depression scores and low CSFQ scores in our study could add to the lowered well-being amongst female patients shown in some studies [ 27 , 49 ]. However, other studies found no gender difference in the prevalence of depression amongst patients with RA [ 1 , 50 ]. These differences may be due to scale measurement bias and would be worthy of further exploration using a male-specific depression scale that addresses ways through which men traditionally express depression (i.e., anger, aggression, substance abuse, self-sabotage and risk-taking behaviours) [ 51 ].…”

Research progress on rheumatoid arthritis-associated depression

“…In addition, there are also gender-related differences in the causes of severity of depression among RA patients. According to McQuillan et al ( 2022 ), RA functional disability is more strongly associated with depression in males than in females. Depressive symptoms in female patients appear to be more closely related to poor sleep quality or family pressure (Hughes et al, 2021 ; Hamasaki et al, 2022 ).…”