Original Article

Modern Rheumatology

, Volume 23, Issue 2, pp 237-244

Major depressive disorder in patients with rheumatoid arthritis

  • Eri SatoAffiliated withInstitute of Rheumatology, Tokyo Women’s Medical University Email author 
  • , Katsuji NishimuraAffiliated withDepartment of Psychiatry, Tokyo Women’s Medical University
  • , Ayako NakajimaAffiliated withInstitute of Rheumatology, Tokyo Women’s Medical University
  • , Hiroshi OkamotoAffiliated withInstitute of Rheumatology, Tokyo Women’s Medical University
  • , Mikiko ShinozakiAffiliated withInstitute of Rheumatology, Tokyo Women’s Medical University
  • , Eisuke InoueAffiliated withInstitute of Rheumatology, Tokyo Women’s Medical University
  • , Atsuo TaniguchiAffiliated withInstitute of Rheumatology, Tokyo Women’s Medical University
  • , Shigeki MomoharaAffiliated withInstitute of Rheumatology, Tokyo Women’s Medical University
  • , Hisashi YamanakaAffiliated withInstitute of Rheumatology, Tokyo Women’s Medical University

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Abstract

Objective

To investigate the point prevalence of major depressive disorder (MDD) as diagnosed by the Mini-International Neuropsychiatric Interview (M.I.N.I) in patients with rheumatoid arthritis (RA) and to determine whether MDD is related to features of RA disease, such as disease activity or physical dysfunction.

Methods

Of the patients with RA who participated in the IORRA survey conducted in October 2005, 162 were evaluated using the M.I.N.I., the Center for Epidemiologic Studies-Depression (CES-D) scale, and the two-question depression screen for MDD. RA clinical features were obtained from the concomitant IORRA cohort database. Relationships between MDD and RA disease features were analyzed by the Wilcoxon rank sum test and Pearson’s chi-square test.

Results

The point prevalence of MDD as diagnosed by the M.I.N.I. was 6.8 % in our Japanese patients with RA. The percentage of depressive patients was determined to be 23.5, 17.3, or 7.4 % according to the CES-D scale with cut-off points of 16, 19, or 27, respectively, and 14.2 % according to the two-question depression screen. The best cut-off point for CES-D for risk of MDD diagnosed by M.I.N.I. in this study was determined to be 23, with 11.7 % depressive patients having the highest sum of sensitivity and specificity. No relationship between MDD and RA disease activity was detected.

Conclusion

By using the well-established structural interview instrument M.I.N.I., we determined the point prevalence of MDD in the RA patients enrolled in this study to be 6.8 %, leading to the conclusion that concomitant MDD does not seem to influence disease activity in RA patients.

Keywords

Rheumatoid arthritis Major depressive disorder Mini-International Neuropsychiatric Interview Prevalence Center for Epidemiologic Studies-Depression Scale