DEPRESSION AS A MODULATOR OF PATIENT REPORTED, BUT NOT PHYSICIAN OBSERVED OUTCOMES IN PSORIATIC ARTHRITIS
Authors: Haberman R et al.
PsA can be associated with a decreased quality of life and high levels of depression and anxiety have been reported. There is limited data on how mental health affects disease activity and its perception and might contribute to persistent fatigue and pain. 537 PsA patients were prospectively recruited at a New York PsA Center and followed for up to two years. Depression was defined as patient-reported and/or use of antidepressants.
Within this cohort, 23% had depression and 18% reported anxiety. At baseline, patients with depression were more likely to be female, older and had concomitant anxiety (50.8%). Despite comparable baseline disease activity parameters, during follow-up patients with depression had higher tender joint counts versus patients without depression even after adjusting for age, sex, biologic use and comorbidities. SJC and BSA remain similar in patients with and without depression.
Patients with PsA frequently present with depression and anxiety. Most patients improve over time, but TJC remain significantly higher in patients with depression versus those without depression. This may reflect how patients with depressions perceive their disease but may interfere with achieving at least low disease activity. Improving management of depression might contribute to achieve better outcomes in this subpopulation of patients.