Year: 2012
Type: dissertation
Study design: Observational Study
Abstract: Background: \nRheumatoid Arthritis (RA) is a chronic auto-immune musculoskeletal disorder of unknown \naetiology that can result in physical disability, chronic pain and impaired quality of life. RA is \nassociated with an increased prevalence of depression. The presence of depression in RA is \nreported to be associated with pain, functional disability, high disease activity and mortality. \nThis study aims to determine the prevalence of depressive symptoms in a cohort of Black \nSouth African patients attending a Rheumatology outpatient clinic at a public health center. It \nalso aims to determine the association and correlation between the presence of depressive \nsymptoms and the sociodemographic profile and RA clinical characteristics of the study \npopulation. \nMethodology: \nThe study was conducted in a Rheumatology out patient clinic. The study sample consisted of \n100 systematically selected participants of Black race. The participants completed the \ndisability questionnaire (HAQ-DI), Visual Analogue Scales (VAS) for pain, fatigue and \ndisease activity; and the depression and tension subscales of the Arthritis Impact Measurement \nScale (AIMS). The MADRS was then administered to assess depressive symptoms. Study participants were clinically assessed for disability, joint status and disease activity. \nData was analyzed using the SAS version 9.1 statistical program. \nResults: \nThe majority of the sample was female (85%) and unmarried (66%). The prevalence of \ncurrent depression was 13.2%, although a further 22.2% of the sample was already stable on \nantidepressant treatment. The mean RA disease duration was 12.5 ± 9.2 years. \nNo significant associations were found between the presence of depression and the \nsociodemographic variables. MADRS scores were significantly associated and correlated with \ndisability (p = 0.002, r = 0.30); fatigue (p = <0.001, r = 0.43); disease activity (p = 0.001, \nr = 0.32); AIMS-D (p < 0.001, r = 0.40) and AIMS-T (p < 0.001, r = 0.35). Upon adjusting for \nage and clinical status, significant associations remained with MADRS scores and all five \nabove-mentioned RA variables although correlations weakened slightly. \nConclusions: \nCo morbid depression is prevalent in South African Black patients with RA. In order to \nimprove clinical outcomes in RA, depression must be actively sought and effectively \nmanaged.
Author: Anersha Pillay
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2285456685