Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms

Zheng, Shuang; Tu, Liudan; Cicuttini, Flavia Maria; Zhu, Zhaohua; Han, Weiyu; Antony, Benny; Wluka, Anita E.; Winzenberg, Tania; Aitken, Dawn; Blizzard, Leigh; Jones, Graeme; Ding, Changhai

doi:10.1186/s12891-020-03875-1

Cited by 62 publications

(58 citation statements)

References 40 publications

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“…These findings are consistent with those reported by Güven et al [ 30 ], who found a negative correlation between total years of education and depression in FM participants. However, in the present study, contrary to previous findings [ 87 , 88 ], education did not significantly predict depression in the OA group. A possible, albeit speculative, explanation could be that difficulties related to the unknown etiology and trajectory of FM, as well as the uncertainty associated with the diagnosis, could account for higher depression scores among those with less education.…”

Section: Discussioncontrasting

confidence: 99%

Health, Psychological and Demographic Predictors of Depression in People with Fibromyalgia and Osteoarthritis

Dyne

Moy

Wash

et al. 2022

IJERPH

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Depression is common in people with fibromyalgia (FM) and osteoarthritis (OA) and has been linked to adverse health outcomes in these conditions. The purpose of this study was to examine differences in predictors of depression among individuals with FM and OA using a range of health, demographic, and psychological variables. Of the total 963 participants, 600 were diagnosed with FM, and 363 with OA. The Quality of Well-Being Scale (QWB) was used to assess health status. The Fibromyalgia Impact Questionnaire (FIQ) and the Arthritis Impact Measurement Scale (AIMS) were used to measure disease-specific impact. Additionally, participants completed self-efficacy and helplessness assessments. Depression was measured using the Center for Epidemiological Studies Scale (CES-D). The results of a moderated linear regression showed that higher depression scores were associated with lower health status and a greater condition impact, especially in the FM group. Self-efficacy and helplessness predicted depression in both groups, but more strongly in FM. White participants with OA were more depressed than their non-White counterparts, while the opposite was true for FM. These findings indicate that improving health status and psychological well-being might alleviate depression in both FM and OA.

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Section: Discussioncontrasting

confidence: 99%

Health, Psychological and Demographic Predictors of Depression in People with Fibromyalgia and Osteoarthritis

Dyne

Moy

Wash

et al. 2022

IJERPH

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“…The inclusion criteria were as follows: (1) obesity (BMI ≥30 kg/m 2 ), (2) idiopathic KOA [ 49 ] with mild to moderate radiographic changes (Kellgren or Lawrence grade 2 or 3 [ 50 ]) or Knee Injury and Osteoarthritis Outcome Scores (KOOSs) consistent with KOA [ 51 ], (3) elevated depressive symptoms with a 9-item Patient Health Questionnaire (PHQ-9) score ≥10 [ 52 , 53 ], (4) aged ≥45 years [ 54 , 55 ], (5) history of concurrent psychotropics for <2 weeks before initiation of treatment or on stable doses for >6 weeks, (6) access to an internet-enabled computer or smartphone, (7) willingness to comply with the study protocol and assessments, and (8) physician’s clearance to participate. We selected the PHQ-9 because it is widely used and validated as a screener in health care settings [ 56 ], including orthopedic clinics [ 57 ], and for patients with KOA [ 58 ]. Given the tendency to underreport emotional symptoms of depression in our rural population, particularly among men, the PHQ-9 is also more likely to detect physical manifestations of depression that overlap with KOA (eg, slow movement and sleep disturbance).…”

Section: Methodsmentioning

confidence: 99%

Live Video Mind-Body Program for Patients With Knee Osteoarthritis, Comorbid Depression, and Obesity: Development and Feasibility Pilot Study

Mace¹,

Greenberg²,

Lemaster³

et al. 2022

JMIR Form Res

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Background Knee osteoarthritis (KOA) is the most common joint disorder in the United States and a leading cause of disability. Depression and obesity are highly comorbid with KOA and accelerate knee degeneration and disability through biopsychosocial mechanisms. Mind-body physical activity programs can engage biological, mechanical, and psychological mechanisms to improve outcomes in KOA, but such programs are not currently available. Objective This mixed methods study aims to adapt a mind-body activity program for the unique needs of patients with KOA, depression, and obesity (GetActive-OA) delivered via live video. Methods Participants were adults (aged ≥45 years) from rural Kentucky with obesity (BMI≥30 kg/m2), idiopathic KOA with mild to moderate radiographic changes, and elevated depressive symptoms (9-item Patient Health Questionnaire ≥10) recruited from 2 orthopedic centers. In phase 1, we developed GetActive-OA and the study protocol using qualitative focus group feedback from the study population (N=9; 2 focus groups, 90 minutes) and multidisciplinary expertise from clinical psychologists and orthopedic researchers. In phase 2, we explored the initial feasibility, credibility, and acceptability of GetActive-OA, live video delivery, and study procedures via an open pilot with exit interviews (N=5; 1 group). This research was guided by National Institutes of Health (NIH) model stage IA. Results Phase 1 qualitative analyses revealed nuanced information about challenges with coping and increasing activity, high interest in a mind-body activity program, program participation facilitators (flexibility with technology) and barriers (amotivation and forgetfulness), and perceived challenges with data collection procedures (blood and urine samples and homework). Phase 2 quantitative analyses showed that GetActive-OA met most a priori feasibility markers: acceptability (80%), expectancy (100%), credibility (100%), clinician adherence (90%), homework adherence (80%), questionnaire data collection (100%), program satisfaction (100%), and safety (100%). Adherence to ActiGraph wear (80% baseline, 20% posttest) and collection of blood samples (60%) were low. Participation in GetActive-OA was associated with signals of improvements in general coping (Cohen d=2.41), pain catastrophizing (Cohen d=1.24), depression (Cohen d=0.88), anxiety (Cohen d=0.78), self-efficacy (Cohen d=0.73), pain (Cohen d=0.39), and KOA symptoms (Cohen d=0.36). Qualitative exit interviews confirmed quantitative findings and provided valuable information to optimize the program and protocol. Conclusions Patients with KOA, depression, and obesity from rural Kentucky were interested in a live video mind-body activity program. GetActive-OA shows promise; however, the program and protocol require further NIH stage I refinement before formal efficacy testing (NIH model stage II). International Registered Report Identifier (IRRID) RR2-10.1016/j.conctc.2021.100720

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“…After a long period of neglect, the number of studies documenting the prevalence of depression in OA has increased in the past decade. Studies in the United States, 8 Canada, 13 Australia, 5 Germany, 14 Portugal, 15 China, 16 Japan, 9 and Korea 17 have provided evidence of an association between OA and depression.…”

Section: Depression and Oa: Epidemiological Associationmentioning

confidence: 99%

“… 23 Recently, Zheng et al found that patients who had KOA and two or more painful body sites at baseline were at increased risk for depression. 16 …”

Section: Depression and Oa: Epidemiological Associationmentioning

confidence: 99%

Depression in Osteoarthritis: Current Understanding

Wang¹,

Ni²

2022

NDT

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Depression, one of the most common comorbidities with osteoarthritis (OA), affects patient prognosis and quality of life. It also increases the overall burden of disease. This subgroup of patients has not been effectively managed in clinical settings. The study aimed to direct physicians’ attention to the co-occurrence of depression and OA. Therefore, this review summarizes the relevant literature published over the past 10 years. The focus is on the prevalence of and risk factors for depression in OA, the effects of depression on OA development and treatment response, comorbidity mechanisms, screening, and non-pharmacological treatment. The research on the etiology of depression has been driven largely by epidemiological studies. Recent studies have shown that high levels of pain, poor levels of function, high numbers of OA sites, and slow gait might be associated with depression. However, the pathophysiology of OA and depression comorbidities remains unclear. In addition to immune inflammation and structural changes in the brain, which have been documented in brain imaging studies, psychosocial factors may also play a role. The evidence indicates that depression can be treated with early intervention; however, adjustments may need to be made for individuals with comorbid depression in OA. It is recommended that health care providers pay more attention to depressive symptoms in patients with OA. Clinicians should develop and implement an individualized and comprehensive treatment plan for patients based on a mental health assessment and in teams with other professionals to optimize treatment outcomes.

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Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms

Cited by 62 publications

References 40 publications

Health, Psychological and Demographic Predictors of Depression in People with Fibromyalgia and Osteoarthritis

Health, Psychological and Demographic Predictors of Depression in People with Fibromyalgia and Osteoarthritis

Live Video Mind-Body Program for Patients With Knee Osteoarthritis, Comorbid Depression, and Obesity: Development and Feasibility Pilot Study

Depression in Osteoarthritis: Current Understanding

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