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How common is depression in patients with polymyalgia rheumatica?

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Abstract

Depression is common in inflammatory disorders such as rheumatoid arthritis and systemic lupus erythematosus and negatively impacts on outcomes. Given the long-term nature of polymyalgia rheumatica (PMR) and its glucocorticoid treatment, these patients may be at an increased risk of depression, although few studies exist to date. This study aimed to investigate the prevalence of, and factors associated with, depression in PMR patients. Prevalent PMR patients (with a first diagnostic code for PMR in the last 3 years) were mailed a postal questionnaire (n = 704) examining PMR symptoms, glucocorticoid use and patient reported comorbidities. Depressive symptoms were assessed using the Patient Health Questionnaire-8 (PHQ-8), with a score of ≥10 defined as current depressive symptoms. Logistic regression was used to examine association between demographics, comorbidity and current depressive symptoms. Five hundred fifty (78%) patients responded, of which 365 (66%) were female, with a mean (SD) age of 74.1 years (8.4). The prevalence of current depressive symptoms was 15% (n = 81) and was significantly associated with female gender: OR 1.87 (95%CI 1.08–3.22), current PMR symptoms: OR 2.1 (1.11–3.97), self-reported acid reflux: OR 1.75 (1.05–2.93) and diabetes: OR 2.86 (1.6–5.09). Older patients were less likely to report current depressive symptoms (OR 0.35 (0.13–0.9) for those >80 years versus those aged 50–59 years). Depressive symptoms are common in patients with PMR patients, especially younger patients and those with comorbidities. Clinicians should consider screening these patients for depressive symptoms and managing them appropriately, as untreated depression may negatively impact on health-related outcomes and quality of life.

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Acknowledgements

The authors would like to thank the staff at Keele University’s Arthritis Research UK Primary Care Centre and the staff and patients of the participating practices and NIHR Clinical Research Networks. This project was undertaken with the support of Keele Clinical Trials Unit, Keele University, UK.

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Authors and Affiliations

  1. Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK

    Arani Vivekanantham, Milica Blagojevic-Bucknall, John Belcher, Christian D. Mallen & Samantha L. Hider

  2. Keele Clinical Trials Unit, David Weatherall Building, Keele University, Keele, Staffordshire, ST5 5BG, UK

    Milica Blagojevic-Bucknall & Kris Clarkson

  3. Haywood Academic Rheumatology Centre, Haywood Hospital, Stoke on Trent, Staffordshire, ST6 7AG, UK

    Samantha L. Hider

Authors
  1. Arani Vivekanantham
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  2. Milica Blagojevic-Bucknall
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  3. Kris Clarkson
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  4. John Belcher
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  5. Christian D. Mallen
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  6. Samantha L. Hider
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Corresponding author

Correspondence to Samantha L. Hider.

Ethics declarations

Ethical approval for the study was obtained from NRES-West Midlands-Staffordshire (Ref 13/WM/0133).

Funding

This report presents independent research funded by the National Institute for Health Research (NIHR). CDM is funded by the NIHR Collaborations for Leadership in Applied Health Research and Care West Midlands, the NIHR School for Primary Care Research and a NIHR Research Professorship in General Practice (NIHR-RP-2014-04-026). MB is funded by the NIHR School for Primary Care Research (SPCR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

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Vivekanantham, A., Blagojevic-Bucknall, M., Clarkson, K. et al. How common is depression in patients with polymyalgia rheumatica?. Clin Rheumatol 37, 1633–1638 (2018). https://doi.org/10.1007/s10067-017-3691-9

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  • DOI: https://doi.org/10.1007/s10067-017-3691-9

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