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. 2018 Jul;70(7):970-978.
doi: 10.1002/acr.23539. Epub 2018 May 21.

Increased Burden of Psychiatric Disorders in Rheumatoid Arthritis

Ruth Ann Marrie  1 , Carol A Hitchon  1 , Randy Walld  1 , Scott B Patten  2 , James M Bolton  1 , Jitender Sareen  1 , John R Walker  1 , Alexander Singer  1 , Lisa M Lix  1 , Renée El-Gabalawy  1 , Alan Katz  1 , John D Fisk  3 , Charles N Bernstein  1 ; Canadian Institutes of Health Research Team in Defining the Burden and Managing the Effects of Psychiatric Comorbidity in Chronic Immunoinflammatory Disease
Collaborators, Affiliations

Increased Burden of Psychiatric Disorders in Rheumatoid Arthritis

Ruth Ann Marrie et al. Arthritis Care Res (Hoboken). 2018 Jul.

Abstract

Objective: We estimated the incidence and prevalence of depression, anxiety disorder, bipolar disorder, and schizophrenia in a population-based cohort with rheumatoid arthritis (RA) as compared to an age-, sex-, and geographically matched cohort without RA.

Methods: Using population-based administrative health data from Manitoba, Canada, we identified persons with incident RA between 1989 and 2012, and a cohort from the general population matched 5:1 on year of birth, sex, and region of residence. We applied validated algorithms for depression, anxiety disorder, bipolar disorder, and schizophrenia to determine the annual incidence of these conditions after the diagnosis of RA, and their lifetime and annual period prevalence. We compared findings between cohorts using negative binomial regression models.

Results: We identified 10,206 incident cases of RA and 50,960 matched individuals. After adjustment for age, sex, socioeconomic status, region of residence, number of physician visits, and year, the incidence of depression was higher in the RA cohort over the study period (incidence rate ratio [IRR] 1.46 [95% confidence interval (95% CI) 1.35-1.58]), as was the incidence of anxiety disorder (IRR 1.24 [95% CI 1.15-1.34]) and bipolar disorder (IRR 1.21 [95% CI 1.00-1.47]). The incidence of schizophrenia did not differ between groups (IRR 0.96 [95% CI 0.61-1.50]). Incidence rates of psychiatric disorders declined minimally over time. The lifetime and annual period prevalence of depression and anxiety disorder were also higher in the RA than in the matched cohort over the study period.

Conclusion: The incidence and prevalence of depression, anxiety disorder, and bipolar disorder are elevated in the RA population as compared to a matched population.

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Figures

Figure 1
Figure 1
Age‐specific average annual incidence of psychiatric disorders in the rheumatoid arthritis (RA) and matched cohorts, in A, depression, B, anxiety disorder, C, bipolar disorder, and D, schizophrenia. Incidence rate ratios (95% confidence intervals) comparing the 2 cohorts are shown at the top of each panel. Results are suppressed for schizophrenia in the 18–24 years age group in the RA cohort to preserve privacy. Color figure can be viewed in the online issue, which is available at http://onlinelibrary.wiley.com/doi/10.1002/acr.23539/abstract.
Figure 2
Figure 2
Crude lifetime and annual period prevalence (95% confidence intervals) of psychiatric disorders in the rheumatoid arthritis (RA) and matched cohorts in 2011.
Figure 3
Figure 3
Age‐specific lifetime and annual period prevalence (95% confidence intervals) of psychiatric disorders in the rheumatoid arthritis (RA) and matched cohorts in 2011, in A, depression, B, anxiety disorder, C, bipolar disorder, and D, schizophrenia. Results are suppressed for schizophrenia and bipolar disorder in the 18–24 years age group in the RA cohort to preserve privacy.
See this image and copyright information in PMC

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