Anxiety and depression in rheumatoid arthritis: Associations with disease activity and treatment status
Egyptian Rheumatologist, cilt.48, sa.3, ss.191-195, 2026 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 48 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.ejr.2026.06.002
- Dergi Adı: Egyptian Rheumatologist
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, EMBASE
- Sayfa Sayıları: ss.191-195
- Anahtar Kelimeler: Anxiety, Biological DMARDs, Depression, Disease activity, Education, Rheumatoid arthritis
- Çukurova Üniversitesi Adresli: Evet
Özet
Background: Rheumatoid arthritis (RA) is associated with significant psychological comorbidities; however, the impact of treatment remains unclear. Aim of the work: To evaluate anxiety and depression in patients with RA and to examine their relationship with disease activity and disease-modifying antirheumatic drugs (DMARDs); conventional synthetic (csDMARDs) versus biological/targeted synthetic (b/tsDMARDs),over time. Patients and methods: This prospective study included 112 patients with RA and 30 control. Patients were categorized into those newly initiating csDMARD ( n = 35) or b/tsDMARD ( n = 41) with a low-to-moderate disease activity (LMDA) as a stable reference group ( n = 36). Assessments were performed at baseline, month 3, and month 6 using the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Hospital Anxiety and Depression Scale (HADS), and the Disease Activity Score (DAS28) were assessed. Results: Patients with RA had higher anxiety and depression scores than controls (HADS-A: 8 (6–11) and HADS-D: 7 (3–9) vs 5 (2–9) and 3(2–6.3), respectively; p = 0.033 and p = 0.007). Baseline DAS28-ESR correlated significantly with HADS-D ( r = 0.42, p < 0.001) and HADS-A ( r = 0.35, p < 0.001). b/tsDMARD group had higher baseline disease activity than csDMARD (p < 0.001). Both treatment groups showed significant clinical improvement over 6 months, with greater reductions in depressive symptoms in the b/tsDMARD group. By month 6, disease activity and psychological scores were comparable to LMDA group. Lower educational level was associated with higher psychological distress (HADS-D: r = −0.31, p < 0.001; BDI: r = −0.33,p < 0.001; BAI: r = −0.34,p < 0.001). Conclusion: Anxiety and depression are common in RA and closely linked to disease activity. Improvements in disease activity parallel psychological recovery, supporting routine psychological assessment within treat-to-target strategies.