Abstract
Rheumatoid arthritis (RA) is a chronic joint autoimmune disease with a higher prevalence of depressive symptoms due to the burden of the disease. There are several patient-self-depression scales used for the assessment and a wide range of variations in the prevalence of depression could be related to this. No evidence was found that reports the most accurate, sensitive, and specific depression instrument through an extensive review in the literature. To determine the most precise depression instrument to evaluate RA patients. A systematic review search was directed, considering type of study, prevalence of depressive symptoms, usage of validated depression scales, and reported scale performance measurements. The data extraction followed the PRISMA guidelines, and the risk of bias was assessed using RoB 2, ROBINS-I, and QUADAS-2. From a total of 1958, only 28 articles included in the analysis. The total number of patients analyzed was 6405, with a mean age of 56.53 years, 4474 women (75.22%), and a mean prevalence of depressive symptoms of 27.4%. The most frequent and the best scale used was the CES-D (n = 12), considering all characteristics. The CES-D reported the best psychometric properties, and it was the most frequently used tool.
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References
Smolen JS, Aletaha D, McInnes IB (2016) Rheumatoid arthritis. Lancet 388(10055):2023–2038
Matcham F, Rayner L, Steer S, Hotopf M (2013) The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology (Oxford) 52(12):2136–2148
Imran MY, Saira Khan EA, Ahmad NM, Farman Raja S, Saeed MA, Ijaz HI (2015) Depression in rheumatoid arthritis, and its relation to disease activity. Pak J Med Sci 31(2):393–397
Boer AC, Huizinga TWJ, van der Helm-van Mil AHM (2019) Depression and anxiety associate with less remission after 1 year in rheumatoid arthritis. Ann Rheum Dis 78(1):e1
Andriushchenko AV, Drobizhev MI, Dobrovol’skiĭ AV (2003) A comparative validation of the scale CES-D, BDI, and HADS(d) in diagnosis of depressive disorders in general practice. Zh Nevrol Psikhiatr Im S S Korsakova 103(5):11–18
Pu D, Luo J, Wang Y, Ju B, Lv X, Fan P, He L (2018) Prevalence of depression and anxiety in rheumatoid arthritis patients and their associations with serum vitamin D level. Clin Rheumatol 37(1):179–184
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6(7):e1000100
Sterne J, Higgins J, Elbers R, Reeves B, editors (2016) Development group for ROBINS-I. Risk of bias tools In Non-Randomized Studies of Interventions (ROBINS-I): detailed guidance [Internet]. Available: https://sites.google.com/site/riskofbiastool/welcome/home/current-version-of-robins-i/robins-i-detailed-guidance-2016. Accessed 11 Sept 2020
Higgins J, Savovic J, Page M, Sterne J, editors (2019) RoB2 Development Group. Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) [Internet]. Available: https://drive.google.com/file/d/19R9savfPdCHC8XLz2iiMvL_71lPJERWK/view?usp=drive_open&usp=embed_facebook. Accessed 11 Sept 2020
Whiting PF, Rutjes AWS, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, Leeflang MM, Sterne JA, Bossuyt PM, QUADAS-2 Group (2011) QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 155(8):529–36
Iaquinta M, McCrone S (2015) An integrative review of correlates and predictors of depression in patients with rheumatoid arthritis. Arch Psyc Nurs 29(5):265–278
Maldonado G, Ríos C, Paredes C, Ferro C, Intriago MJ, Aguirre C, Ávila V, Moreno M (2017) Depresión en artritis reumatoide. Rev Colomb Reumatol 24(2):84–91
Pincus T, Hassett AL, Callahan LF (2009) Criterion contamination of depression scales in patients with rheumatoid arthritis: the need for interpretation of patient questionnaires (as all clinical measures) in the context of all information about the patient. Rheum Dis Clin N Am 35(4):861–864
de Yébenes MJG, Loza E (2018) Artritis reumatoide: epidemiología e impacto sociosanitario. Reumatol Clin 14(2):3–6
del Hérnandez LC, Querol J, De la Garza AL, Férnandez C (2016) Artritis Reumatoide su impacto social y económico. Boletín Epidemiológico 33(12):1–4
Martens MP, Parker JC, Smarr KL, Hewett JE, Slaughter JR, Walker SE (2003) Assessment of depression in rheumatoid arthritis: a modified version of the center for epidemiologic studies depression scale. Arthritis Rheum 49(4):549–555
Covic T, Pallant JF, Tennant A, Cox S, Emery P, Conaghan PG (2009) Variability in depression prevalence in early rheumatoid arthritis: a comparison of the CES-D and HAD-D scales. BMC Musculoskelet Disord 10(1):18
Murray JL (1996) Depressive symptoms in rheumatoid arthritis: the quantitative and qualitative assessment of self-esteem. University of Glasgow, Glasgow
Smedstad LM, Mourn T, Vaglum P, Kvien TK (1996) The impact of early rheumatoid arthritis on psychological distress. Scand J Rheumatol 25(6):377–382
Fifield J, McQuillan J, Tennen H, Sheehan TJ, Reisine S, Hesselbrock V, Rothfield N (2001) History of affective disorder and the temporal trajectory of fatigue in rheumatoid arthritis. Ann Behav Med 23(1):34–41
Covic T (2003) A biopsychosocial model of pain and depression in rheumatoid arthritis: a 12-month longitudinal study. Rheumatology 42(11):1287–1294
Covic T, Tyson G, Spencer D, Howe G (2006) Depression in rheumatoid arthritis patients: demographic, clinical, and psychological predictors. J Psychosom Res 60(5):469–476
Morris A, Yelin EH, Wong B, Katz PP (2008) Patterns of psychosocial risk and long-term outcomes in rheumatoid arthritis. Psychol Health Med 13(5):529–44
Dirik G, Karanci AN (2010) Psychological distress in rheumatoid arthritis patients: an evaluation within the conservation of resources theory. Psychol Health 25(5):617–632
Morris A, Yelin EH, Panopalis P, Julian L, Katz PP (2011) Long-term patterns of depression and associations with health and function in a panel study of rheumatoid arthritis. J Health Psychol 16(4):667–77
Hyphantis T, Kotsis K, Tsifetaki N, Creed F, Drosos AA, Carvalho AF, Voulgari PV (2013) The relationship between depressive symptoms, illness perceptions and quality of life in ankylosing spondylitis in comparison to rheumatoid arthritis. Clin Rheumatol 32(5):635–644
Behnam B, Moghimi J, Ghorbani R, Ghahremanfard F (2013) The frequency and major determinants of depression in patients with rheumatoid arthritis. Turkish J Rheumatol 28(1):32–37
Stephenson E, DeLongis A, Esdaile JM, Lehman AJ (2014) Depressive symptoms and rheumatoid arthritis: spouse empathic responding as a buffer: spouse depression and empathic responding in RA. Arthritis Care Res 66(4):532–541
Cabrera-Marroquín R, Contreras-Yáñez I, Alcocer-Castillejos N, Pascual-Ramos V (2014) Major depressive episodes are associated with poor concordance with therapy in rheumatoid arthritis patients: the impact on disease outcomes. Clin Exp Rheumatol 32:904–913
Wan SW, He HG, Mak A, Lahiri M, Luo N, Cheung PP, Wang W (2016) Health-related quality of life and its predictors among patients with rheumatoid arthritis. Appl Nurs Res 30:176–183
Rice D, Mehta S, Shapiro A, Pope J, Harth M, Morley-Forster P, Sequeira K, Teasell R (2016) Psychological distress in out-patients assessed for chronic pain compared to those with rheumatoid arthritis. Pain Res Manag 2016:1–7
Soósová MS, Macejová Ž, Zamboriová M, Dimunová L (2017) Anxiety, and depression in Slovak patients with rheumatoid arthritis. J Ment Health 26(1):21–27
Liu L, Xu N, Wang L (2017) Moderating role of self-efficacy on the associations of social support with depressive and anxiety symptoms in Chinese patients with rheumatoid arthritis. Nephrol Dial Transplant 13:2141–2150
McQuillan J, Fifield J, Sheehan TJ, Reisine S, Tennen H, Hesselbrock V, Rothfield N (2003) A comparison of self-reports of distress and affective disorder diagnoses in rheumatoid arthritis: a receiver operator characteristic analysis. Arthritis Rheum 49(3):368–376
Covic T, Pallant JF, Conaghan PG, Tennant A (2007) A longitudinal evaluation of the center for epidemiologic studies-depression scale (CES-D) in a rheumatoid arthritis population using rasch analysis. Health Qual Life Outcomes 5(1):41
Sato E, Nishimura K, Nakajima A, Okamoto H, Shinozaki M, Inoue E et al (2013) Major depressive disorder in patients with rheumatoid arthritis. Modern Rheumatol 23(2):237–244
Matcham F, Norton S, Steer S, Hotopf M (2016) Usefulness of the SF-36 Health Survey in screening for depressive and anxiety disorders in rheumatoid arthritis. BMC Musculoskelet Disord 17(1):224
Hu H, Luan L, Yang K, Li S (2016) Psychological distress in Chinese patients with rheumatoid arthritis and psychometric validation of Chinese hospital anxiety and depression scale. Value Health 19(7):A917
Engelbrecht M, Alten R, Aringer M, Baerwald CG, Burkhardt H, Eby N, Fliedner G, Gauger B, Henkemeier U, Hofmann MW, Kleinert S, Krueger K, Pohl C, Roske AE, Scheet G, Schmalsing M, Teusche AK, Peter-Tony H, Wendler J (2017) Validation of standardized questionnaires evaluating symptoms of depression in rheumatoid arthritis patients: approaches to screening for a frequent yet underrated challenge: depression questionnaire validation in RA patients. Arthritis Care Res 69(1):58–66
Hitchon CA, Zhang L, Peschken CA, Lix LM, Graff LA, Fisk JD, Patten SB, SareenJ E-G, Marriot J, Bernsteind CN, Marrie RA (2020) Validity and reliability of screening measures for depression and anxiety disorders in rheumatoid arthritis. Arthritis Care Res 72(8):1130–1139
Slaughter JR, Parker JC, Martens MP, Smarr KL, Hewett JE (2002) Clinical outcomes following a trial of sertraline in rheumatoid arthritis. Psychosom 43(1):36–41
Parker JC, Smarr KL, Slaughter JR, Johnston SK, Priesmeyer ML, Donovan HK, Johnson GE, Hewett JE, Hewett JE, Irvin WS, Komatireddy GR, Walker S (2003) Management of depression in rheumatoid arthritis: a combined pharmacologic and deccognitive-behavioural approach. Arthritis Rheum 49(6):766–777
Edalatjoo Z, Zarbakhsh M, Shamsaldini A (2019) Determining the effectiveness of cognitive behavioral training on the rate of C-reactive protein and depression in patients afflicted with rheumatoid arthritis. Int Clin Neurosci J 6(2):64–68
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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Databases from the Universidad Autonoma de Ciudad Juárez, Campus RIMA, Universidad Nacional Autonoma de Mexico, and Instituto Politecnico Nacional were important to get access to the articles and thus to elaborate this manuscript.
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M-SAV took part in conceptualization, methodology, validation, formal analysis, investigation, data curation, writing—original draft. V-RL involved in writing—original draft, writing—review and editing. H-DC involved in conceptualization, methodology, investigation, resources, data curation, writing—original draft, writing—review and editing, visualization, supervision.
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Meza-Sánchez AV, Ventura-Rios L, Hernández-Diaz C declare that they have no conflict of interest.
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Victoria, MS.A., Lucio, VR. & Cristina, HD. Patient self-reported instruments for assessing symptoms in rheumatoid arthritis. Rheumatol Int 43, 1781–1790 (2023). https://doi.org/10.1007/s00296-023-05355-w
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DOI: https://doi.org/10.1007/s00296-023-05355-w