Associations of Rheumatoid Arthritis and Depressive Symptoms Over Time: Are There Differences by Education, Race/Ethnicity, and Gender?

Authors

Julia McQuillan, University of Nebraska - LincolnFollow
Jennifer A. Andersen, University of Arkansas for Medical Sciences Northwest,
Terceira A. Berdahl, Agency for Healthcare Research and Quality
Jeff Willett, American Heart Association

ORCID IDs

Jennifer A. Andersen https://orcid.org/0000-0001-6809-892X

Document Type

Article

Date of this Version

2022

Citation

Arthritis Care & Research 2022, pp 1–9

DOI 10.1002/acr.24730

Comments

This article has been contributed to by US Government employees and their work is in the public domain in the USA.

Abstract

Objective. To examine associations between changes in rheumatoid arthritis (RA) symptoms and depressive symptoms adjusted for other time-varying characteristics, and to test if these associations differed by education, race/ethnicity, or gender.

Methods. Data from the 1988–1998 US National Rheumatoid Arthritis Study were analyzed (n = 854). Time-varying covariates included year of the study, pain, functional ability, household work disability, parental status, marital status, employment status, and social support. The time-invariant covariates included years since diagnosis, education, race/ ethnicity, and gender. Multivariate multilevel-model analyses were used to estimate associations within people over time.

Results. Patients with RA experience considerable change in depressive symptoms, pain, functional disability, and household work disability over the study period. Depressive symptoms were driven more by differences between people compared to changes within people over time. Findings show that patients experienced increases in depressive symptoms over the study period. The rate of change in depressive symptoms did not differ by education, race/ethnicity, or gender. Times of worse pain, functional disability, and household disability were associated with worse depressive symptoms. The association of functional disability and depressive symptoms was stronger for men than women.

Conclusion. Increases in pain and disability were associated with worse depressive symptoms, adjusted for covariates. It is important to monitor and treat both mental and physical health symptoms. Future research efforts should focus on collecting data reflecting the educational, gender, and racial/ethnic diversity of individuals with RA.