Advertisement

Rheumatology International

, Volume 27, Issue 9, pp 859–863 | Cite as

The impact of concomitant depression on quality of life and health service utilisation in patients with osteoarthritis

  • Thomas RosemannEmail author
  • Jochen Gensichen
  • Nina Sauer
  • Gunter Laux
  • Joachim Szecsenyi
Original Article

Abstract

To assess the impact of concomitant depression on quality of life (QoL) and health service utilisation of patients with osteoarthritis (OA). Data were collected from 75 primary care practices in Germany. Totally, 1,250 patients were consecutively approached; 1,021 (81.7%) questionnaires were returned and analysed. Measures included sociodemographic data, the Arthritis Impact Measurement Scale (AIMS2-SF) and the Patient Health Questionnaire (PHQ-9) to assess depression. A PHQ-9 score ≥ 15 was defined as reflecting depression. Patients with a depressive disorder achieved significantly (all P < 0.001) higher scores in all AIMS2-SF dimensions. They had more contacts to general practitioners (P < 0.01), orthopaedics (P < 0.01) and to providers of Complementary Alternative Medicine offered e.g. by healers. Concomitant depression aggravates the burden of OA significantly. This results in increased health service utilisation. Appropriate treatment of depression would appear not only to increase QoL but also to lower costs by decreasing health service utilisation.

Keywords

Depression Osteoarthritis Quality of life Health service utilisation Primary care 

References

  1. 1.
    Roseman T, Backenstrass M, Rosemann A, et al. (2006) Predictors of depression in a sample of 1021 primary care patients with Osteoarthritis. Arthritis Care Res (in press)Google Scholar
  2. 2.
    Creamer P, Hochberg MC (1998) The relationship between psychosocial variables and pain reporting in osteoarthritis of the knee. Arthritis Care Res 11:60–65PubMedCrossRefGoogle Scholar
  3. 3.
    Alexopoulos GS (2005) Depression in the elderly. Lancet 365:1961–1970PubMedCrossRefGoogle Scholar
  4. 4.
    Groessl EJ, Kaplan RM, Cronan TA (2003) Quality of well-being in older people with osteoarthritis. Arthritis Rheum 49:23–28PubMedCrossRefGoogle Scholar
  5. 5.
    Jordan KM, Sawyer S, Coakley P, et al. (2004) The use of conventional and complementary treatments for knee osteoarthritis in the community. Rheumatology (Oxford) 43:381–384CrossRefGoogle Scholar
  6. 6.
    Li X, Gignac MA, Anis AH (2006) The indirect costs of arthritis resulting from unemployment, reduced performance, and occupational changes while at work. Med Care 44:304–310PubMedCrossRefGoogle Scholar
  7. 7.
    Solignac M (2004) COART France 2003 report on new socioeconomic data on osteoarthritis in France. Presse Med 33:S4–S6PubMedGoogle Scholar
  8. 8.
    Altman R, Alarcon G, Appelrouth D, et al. (1991) The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum 34:505–514PubMedCrossRefGoogle Scholar
  9. 9.
    Altman R, Asch E, Bloch D, et al. (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 29:1039–1049PubMedCrossRefGoogle Scholar
  10. 10.
    Spitzer RL, Kroenke K, Williams JB (1999) Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. Patient Health Questionnaire. JAMA 282:1737–1744PubMedCrossRefGoogle Scholar
  11. 11.
    American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. Washington, DCGoogle Scholar
  12. 12.
    Lowe B, Kroenke K, Herzog W, Grafe K (2004) Measuring depression outcome with a brief self-report instrument: sensitivity to change of the Patient Health Questionnaire (PHQ-9). J Affect Disord 81:61–66PubMedCrossRefGoogle Scholar
  13. 13.
    Backenstrass M, Frank A, Joest K, et al. (2006) A comparative study of nonspecific depressive symptoms and minor depression regarding functional impairment and associated characteristics in primary care. Compr Psychiatry 47:35–41PubMedCrossRefGoogle Scholar
  14. 14.
    Rosemann T, Korner T, Wensing M, Schneider A, Szecsenyi J (2005) Evaluation and cultural adaptation of a German version of the AIMS2-SF questionnaire (German AIMS2-SF). Rheumatology (Oxford) 44:1190–1195CrossRefGoogle Scholar
  15. 15.
    Craig CL, Marshall AL, Sjostrom M, et al. (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35:1381–1395PubMedCrossRefGoogle Scholar
  16. 16.
    Parker G, Roy K (2001) Adolescent depression: a review. Aust N Z J Psychiatry 35:572–580PubMedCrossRefGoogle Scholar
  17. 17.
    Friedland J, McColl M (1992) Disability and depression: some etiological considerations. Soc Sci Med 34:395–403PubMedCrossRefGoogle Scholar
  18. 18.
    Haworth JE, Moniz-Cook E, Clark AL, et al. (2005) Prevalence and predictors of anxiety and depression in a sample of chronic heart failure patients with left ventricular systolic dysfunction. Eur J Heart Fail 7:803–808PubMedCrossRefGoogle Scholar
  19. 19.
    Mancuso CA, Peterson MG, Charlson ME (2000) Effects of depressive symptoms on health-related quality of life in asthma patients. J Gen Intern Med 15:301–310PubMedCrossRefGoogle Scholar
  20. 20.
    Dunlop DD, Lyons JS, Manheim LM, Song J, Chang RW (2004) Arthritis and heart disease as risk factors for major depression: the role of functional limitation. Med Care 42:502–511PubMedCrossRefGoogle Scholar
  21. 21.
    Waxman HM, Carner EA, Blum A (1983) Depressive symptoms and health service utilization among the community elderly. J Am Geriatr Soc 31:417–420PubMedGoogle Scholar
  22. 22.
    Arnow BA, Hunkeler EM, Blasey CM, et al. (2006) Comorbid depression, chronic pain, and disability in primary care. Psychosom Med 68:262–268PubMedCrossRefGoogle Scholar
  23. 23.
    Lam CL, Lauder IJ (2000) The impact of chronic diseases on the health-related quality of life (HRQOL) of Chinese patients in primary care. Fam Pract 17:159–166PubMedCrossRefGoogle Scholar
  24. 24.
    Ang DC, Choi H, Kroenke K, Wolfe F (2005) Comorbid depression is an independent risk factor for mortality in patients with rheumatoid arthritis. J Rheumatol 32:1013–1019PubMedGoogle Scholar
  25. 25.
    van der Bij AK, Laurant MG, Wensing M (2002) Effectiveness of physical activity interventions for older adults: a review. Am J Prev Med 22:120–133PubMedCrossRefGoogle Scholar
  26. 26.
    Minor MA (2004) Impact of exercise on osteoarthritis outcomes. J Rheumatol Suppl 70:81–86PubMedGoogle Scholar
  27. 27.
    Warsi A, LaValley MP, Wang PS, Avorn J, Solomon DH (2003) Arthritis self-management education programs: a meta-analysis of the effect on pain and disability. Arthritis Rheum 48:2207–2213PubMedCrossRefGoogle Scholar
  28. 28.
    Brander VA, Stulberg SD, Adams AD, et al. (2003) Predicting total knee replacement pain: a prospective, observational study. Clin Orthop Relat Res (416):27–36Google Scholar
  29. 29.
    Brandt KD, Heilman DK, Slemenda C, et al. (2000) A comparison of lower extremity muscle strength, obesity, and depression scores in elderly subjects with knee pain with and without radiographic evidence of knee osteoarthritis. J Rheumatol 27:1937–1946PubMedGoogle Scholar
  30. 30.
    Lowe B, Spitzer RL, Grafe K, et al. (2004) Comparative validity of three screening questionnaires for DSM-IV depressive disorders and physicians’ diagnoses. J Affect Disord 78:131–140PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Thomas Rosemann
    • 1
    Email author
  • Jochen Gensichen
    • 2
  • Nina Sauer
    • 3
  • Gunter Laux
    • 1
  • Joachim Szecsenyi
    • 1
  1. 1.Department of General Practice and Health Services ResearchUniversity Hospital of HeidelbergHeidelbergGermany
  2. 2.Institute for General Practice, Chronic Care and Health Services Research UnitUniversity of FrankfurtFrankfurt a.M.Germany
  3. 3.Department of Internal MedicineUniversity Hospital of HeidelbergHeidelbergGermany

Personalised recommendations