Epidemiology of depression and anxiety in patients with psoriatic arthritis: A systematic review and meta-analysis

Zusman, Enav Z.; Howren, Alyssa; Park, Jamie Y.E.; Dutz, Jan P.; Vera, Mary A. De

doi:10.1016/j.semarthrit.2020.02.001

Cited by 36 publications

(45 citation statements)

References 37 publications

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“…As a result, the lack of data on the possible concomitant presence of fibromyalgia for which antidepressants and anxiolytics are commonly prescribed may confound our results. On the other hand, not all patients with RA or PsA and concomitant depression use antidepressants, 20 28 therefore our approach has clearly missed some of them. Although a comparison of our findings with antidepressant and anxiolytic prescription patterns in a non-IRD population would be revealing, it would require data for which we have not requested access.…”

Section: Discussionmentioning

confidence: 98%

“…8 Furthermore, it is well 2846 (28) 3813 2531 291 257 226 174 215 (2) Other csDMARDs (%) 205 (11) 703 (7) 649 4382 (27) 929 (21) 366 (14) 166 (8) 292 (8) 74 7bDMARDs (17) 1554 (15) 2095 (14) 338 (24) 972 (22) 409 (16) 180 (8) 410 (11) 97 (10) Glucocorticoids (%) (12) 2394 (23) 3988 (26) 143 (10) 834 (19) 591 (23) 235 (11) 673 (18) 208 (21) bDMARD, biologic DMARD; cDMARD, conventional synthetic DMARD; DMARD, disease modifying anti-rheumatic drugs; TNF, tumour necrosis factor. 281 (6) 310 (5) 193 (17) 370 (12) 134 (10) 406 (20) 471 (14) 119 (13) Female (%)…”

Section: Discussionmentioning

confidence: 99%

“…18 Likewise, patients with AS and PsA showed higher rates of anxiolytic usage compared with patients with RA. So far, metaanalyses and cohort studies have shown higher odds for depression among patients with RA, PsA and AS [19][20][21][22] compared with the general population. Depression in rheumatic diseases has been associated with impaired health-related quality of life, 23 worse response to treatment and lower improvement in disease activity over time.…”

Section: Inflammatory Arthritismentioning

confidence: 99%

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Introduction and switching of biologic agents are associated with antidepressant and anxiolytic medication use: data on 42 815 real-world patients with inflammatory rheumatic disease

et al. 2020

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ObjectivesDepression and anxiety are linked bi-directionally with inflammatory rheumatic diseases (IRDs) activity, which in turn, depends on subjective patient reported outcomes that can be distorted by comorbid mood disorders. We tested the hypothesis that introduction and/or switching of biologic agents for IRDs are associated with treatment for depression and/or anxiety, by analysing real-world data.MethodsUsing a country-wide electronic prescription database (10 012 604 registered, 99% population coverage), we captured almost all patients with rheumatoid arthritis (n=12 002), psoriatic arthritis (n=5465) and ankylosing spondylitis (n=6423) who received biologic disease modifying anti-rheumatic drugs (bDMARDs) during a 2-year period (8/2016–7/2018). Concomitant antidepressant/anxiolytic medication use was documented in patients who started or switched bDMARDs and compared with those who remained on conventional synthetic (cs)DMARDs or the same bDMARD, respectively, by multivariate regression analysis.ResultsTwo-year data analysis on 42 815 patients revealed that bDMARD introduction was associated with both antidepressant [OR: 1.248, 95% CI 1.153 to 1.350, p<0.0001] and anxiolytic medication use [OR: 1.178, 95% CI 1.099 to 1.263, p<0.0001]. Moreover, bDMARD switching was also associated with antidepressant [OR: 1.502, 95% CI 1.370 to 1.646, p<0.0001] and anxiolytic medication use [OR: 1.161, 95% CI 1.067 to 1.264, p=0.001]. Notably, all these associations were independent of age, gender, underlying disease diagnosis and concomitant glucocorticoid or csDMARD medication use.ConclusionIn real-world settings, both introduction and switching of bDMARDs in patients with IRDs were associated with the presence of mood disorders. Although a causal relationship is uncertain, the impact of depression and anxiety should always be considered by physicians facing the decision to introduce or switch bDMARDs in patients with active IRDs.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Inflammatory Arthritismentioning

confidence: 99%

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Introduction and switching of biologic agents are associated with antidepressant and anxiolytic medication use: data on 42 815 real-world patients with inflammatory rheumatic disease

et al. 2020

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Section: Introductionmentioning

confidence: 99%

“…Depression is acknowledged as frequent comorbidity in inflammatory arthritis (1)(2)(3)(4). Psoriatic arthritis (PsA) is one of the diseases summarized under the "inflammatory arthritis" label, with reported prevalence rates for depression of about 13-20% (1,2). PsA is found in 0.1-1% of the general population and is particularly frequent in patients with psoriasis (∼20%) involving the skin, nails, joints, and entheses (5).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Depressive Symptoms in Patients With Psoriatic Arthritis: Have Numbers Changed During the COVID-19 Pandemic?

Englbrecht¹,

Bartz‐Bazzanella

Decken

et al. 2021

Front. Med.

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This longitudinal analysis compares the prevalence of depressive symptoms in patients with psoriatic arthritis in the context of the COVID-19 pandemic. Data from a national patient register in Germany were analyzed regarding the Patient Health Questionnaire 2 (PHQ-2) to identify cases suspicious for depression at two time points, i.e., before and during the COVID-19 pandemic. Only patients with complete concurrent information on the Disease Activity in Psoriatic Arthritis Score (DAPSA) were included in the analysis. The frequency of depressive symptoms in psoriatic arthritis patients during the COVID-19 pandemic did not differ from the prevalence rates measured before. In addition, prevalence rates for depressive symptoms did not differ when stratifying the patient sample for DAPSA levels of disease activity measured before the pandemic. These results were confirmed further in a sensitivity analysis, limiting the second PHQ-2 assessment to lockdown periods only. However, longitudinal data on the prevalence of depressive symptoms in patients with rheumatic diseases, in general, and psoriatic arthritis, in particular, are scarce in the context of the COVID-19 pandemic. For a sensible comparison of prevalence rates for depressive symptoms in the future, underlying SARS-CoV-2 infection rates and resulting local healthcare disruptions need to be taken into account, besides the potential use of different depression screening tools to evaluate resulting numbers sensibly and draw corresponding conclusions for patient care.

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“What Came First?” Population‐Based Evaluation of Health Care Encounters for Depression and Anxiety Before and After Inflammatory Arthritis Diagnosis: Disentangling the Relationship Between Mental Health and Arthritis

Howren,

Sayre,

Avina‐Zubieta

et al. 2024

Arthritis Care & Research

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ObjectiveDescribe patterns of depression and anxiety health care use pre‐ and post‐diagnosis among patients with inflammatory arthritis (IA), namely ankylosing spondylitis (AS), psoriatic arthritis (PsA), and rheumatoid arthritis (RA).MethodsWe used population‐based linked administrative health data from British Columbia, Canada to build a cohort of patients (≥18 years) with incident IA and individuals without IA (‘IA‐free controls’) matched on age and sex. We computed the proportion of IA patients and controls having ≥1 depression or ≥1 anxiety health care encounter and use of ≥1 antidepressant or ≥1 anxiolytic in each yearly interval 5‐years pre‐ and post‐IA diagnosis. We used multivariable logistic regression models to evaluate the association between IA status and aforementioned depression and anxiety health care use outcomes in each yearly interval.Results80,238 individuals with IA (62.9% female; mean age 56.2 ±16.7 years) and 80,238 IA‐free controls (62.9% female; mean age 56.2 ±16.6 years) were identified between 01/01/2001 to 03/31/2018. Individuals with IA had significantly increased odds of depression and anxiety health care encounters and dispensation of antidepressants and anxiolytics, for each yearly interval pre‐ and post‐diagnosis. Adjusted odds ratios (aORs) were highest in the year immediately before (≥1 depression visit: aOR 1.61, 95% confidence interval [CI] 1.55 to 1.66; ≥1 anxiolytic: aOR 1.71, 95% CI 1.66 to 1.77) or after (≥1 antidepressant: aOR 1.95, 95% CI 1.89 to 2.00) IA diagnosis.ConclusionFindings suggest a role for depression and anxiety in characterizing the IA prodrome and generate hypotheses regarding overlapping biopsychosocial processes that link IA and mental health comorbidities.image

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Epidemiology of depression and anxiety in patients with psoriatic arthritis: A systematic review and meta-analysis

Cited by 36 publications

References 37 publications

Introduction and switching of biologic agents are associated with antidepressant and anxiolytic medication use: data on 42 815 real-world patients with inflammatory rheumatic disease

Introduction and switching of biologic agents are associated with antidepressant and anxiolytic medication use: data on 42 815 real-world patients with inflammatory rheumatic disease

Prevalence of Depressive Symptoms in Patients With Psoriatic Arthritis: Have Numbers Changed During the COVID-19 Pandemic?

“What Came First?” Population‐Based Evaluation of Health Care Encounters for Depression and Anxiety Before and After Inflammatory Arthritis Diagnosis: Disentangling the Relationship Between Mental Health and Arthritis

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