Even though people with rheumatoid arthritis (RA) may be at increased risk for depression, the subject is rarely discussed with their doctors, says a U.S. study that included 200 RA patients at four rheumatology clinics.
The researchers, led by Betsy Sleath, of the University of North Carolina at Chapel Hill, assessed the patients' mental health and recorded patient/rheumatologist medical visits.
They found that 11 percent of the patients had moderately severe to severe symptoms of depression, which was significantly more likely to occur in patients whose activities were more restricted due to their disease.
However, only 20 percent of patients with depression symptoms discussed the issue with their doctors. When this did happen, it was always brought up by the patients instead of the doctors. When depression was discussed, it was often only for a short period of time.
The study was published in the February issue of Arthritis Care & Research.
It's important for rheumatologists to address both RA and depression when they see patients, the researchers said. If a doctor isn't comfortable discussing depression with patients, they can have office staff conduct a brief depression screening before patient visits to identify depression problems at an early stage.
If depression is a concern, rheumatologists can treat it themselves, refer patients to a mental health specialist, or discuss the matter with a patient's primary-care doctor to coordinate a treatment plan, the study authors suggested. They also recommended that rheumatology training programs include education about the importance of screening for and treating depression.
"Failure to detect and treat depression may compromise patients' adherence to regimens and, ultimately, their health outcomes," the researchers concluded. "Future research should examine patient- and physician-reported barriers to communicating about depression in rheumatology practices and use these findings to design innovative interventions that can be delivered effectively in busy rheumatologist practices."