Prevalence of depression and anxiety in rheumatoid arthritis patients and their associations with serum vitamin D level

Abstract

Vitamin D deficiency may be associated with depression in the general population. This study aimed to describe the prevalence of depression and anxiety in rheumatoid arthritis (RA) patients from Northwestern China and identify associations of Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) scores with serum vitamin D level in these patients. We recruited 161 RA patients inform the First Affiliated Hospital of Xi'an Jiaotong University during Nov. 2016 to Feb. 2017. All patients completed a survey including HAMD and HAMA scales. RA activity (DAS28) was scored by a rheumatologist, and serum 25-OH-D3 levels were measured by electrochemiluminescence immunoassay. The data were analyzed using the SPSS16.0 based on "possible and probable" cut points for HAMD and HAMA. About 62 and 60% of patients had some degrees of depression and anxiety, respectively. The mean of serum 25-OH-D3 levels in RA patients with depression was 15.24 ± 8.78 ng/mL, which was significantly lower than those without depression (24.68 ± 10.98 ng/mL, p = 0.009). Despite negative correlations between serum 25-OH-D3 level and the score of HAMD (r = - 0.520, p < 0.001) or HAMA (r = - 0.469, p < 0.001), there was a positive correlations between DAS28and the score of HAMD (r = 0.459, p = 0.001) or HAMA (r = 0.486, p < 0.001). The multivariate logistic regression showed that disease duration, serum 25-OH-D3 level, and treatment of tumor necrosis factor inhibitor were associated with depression/anxiety in RA patients. Our study shows a high prevalence of depression and anxiety in RA patients from Northwestern China. Both disease activity of RA and low serum 25-OH-D3 level are associated with the severity of depression and anxiety. It is imperative for clinicians to screen hypovitaminosis of vitamin D and depression/anxiety in RA patients.

The effect of vitamin D supplement on negative emotions: A systematic review and meta‐analysis

“…There have been many studies exploring the potential associations between vitamin D and psychological phenomena or psychiatric disorders, including depression (Alavi, Khademalhoseini, Vakili, & Assarian, 2018; Amini, Jafarirad, & Amani, 2018; Bertone‐Johnson et al, 2012; Dumville et al, 2006; Ghaderi et al, 2017; Jorde, Sneve, Figenschau, Svartberg, & Waterloo, 2008; Khoraminya, Tehrani‐Doost, Jazayeri, Hosseini, & Djazayery, 2013; Pittampalli et al, 2018), anxiety (Armstrong et al, 2007; Huang et al, 2014; Pu et al, 2018), psychotic disorders (Chiang, Natarajan, & Fan, 2016), cognitive impairment (Degner, 2016; Etgen, Sander, Bickel, Sander, & Forstl, 2012), sleep disturbance (Gao et al, 2018; Ghaderi et al, 2017), autism spectrum disorder (Moradi et al, 2018; Patrick & Ames, 2014), and substance use (Ghaderi et al, 2017). Studies investigating the relationship between vitamin D and depression are the most common.…”

Disease activity, morning stiffness and missing teeth are associated with oral health-related quality of life in individuals with rheumatoid arthritis

“…This is because patients suffering from RA show distinct changes in their quality of life that are caused not only by direct effects of the underlying disease but also by different psychological factors [2]. Accordingly, a reduced quality of life and a high prevalence of anxiety and depression can be observed in RA patients [3].…”

Prevalence of Depression Among Patients With Vitamin D Disturbance and Response to Treatment at Armed Hospitals, Taif 2018

“…However the difference was not significant. Conflicting results have been reported as some studies have demonstrated a strong relationship between vitamin D and depression (8,(15)(16)(17) whereas others have shown no association (9,18,19). In Netherlands, Milaneschi Y, et al reported a significant correlation between vitamin D level and depressive symptoms at a two-year follow up (20).…”