OBJECTIVE To investigate trends in depression and anxiety over 3 decades among individuals with rheumatoid arthritis (RA). METHODS Patients with incident RA (age ≥ 18 years, meeting 1987 American College of Rheumatology criteria between 1985 and 2014) were identified using the Rochester Epidemiology Project. Individuals with RA were matched 1:1 with non-RA comparators on age, sex, and calendar year of RA incidence. Patients were followed until death, migration, or December 31, 2020. Depression and anxiety were defined using established International Classification of Diseases, 9th and 10th revision code sets. Cox models were used to compare trends in the occurrence of depression and anxiety diagnoses and cooccurring anxiety and depression by decade and RA status, adjusted for potential confounders. RESULTS The study included 1012 individuals with RA and 1012 matched controls (mean age 55.9 years, 68.38% female). Hazard ratios (HRs) demonstrated a temporal increase in anxiety and cooccurring anxiety and depression from 2005-2014 compared to 1985-1994 for individuals both with and without RA. Persons with RA exhibited a rising occurrence of anxiety (HR 1.27, 95% CI 0.86-1.88) and concomitant anxiety and depression (HR 1.49, 95% CI 0.96-2.33) compared to controls. Trends were most pronounced in seropositive patients with RA (anxiety: HR 4.01, 95% CI 2.21-7.30). CONCLUSION Anxiety and concomitant anxiety and depression diagnoses are elevated in individuals with RA. The increasing occurrence of anxiety and cooccurring anxiety and depression suggests rising awareness and diagnosis of these disorders. Adding to stable but high rates of depression diagnoses, individuals with RA now have evidence of a widening gap in mental health diagnoses that clinicians should address.

中文翻译：

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类风湿性关节炎患者焦虑和抑郁的趋势：一项基于人群的研究。


目的 调查类风湿性关节炎 （RA） 患者 3 年来抑郁和焦虑的趋势。方法 使用罗切斯特流行病学项目确定新发 RA 患者 （年龄 ≥ 18 岁，在 1985 年至 2014 年间符合 1987 年美国风湿病学会标准）。RA 患者与 RA 患者的年龄、性别和 RA 发病率日历年 1：1 匹配。对患者进行随访直至死亡、迁移或 2020 年 12 月 31 日。抑郁和焦虑使用已建立的国际疾病分类第 9 版和第 10 版代码集进行定义。Cox 模型用于比较按十年和 RA 状态划分的抑郁和焦虑诊断以及焦虑和抑郁同时发生的趋势，并针对潜在的混杂因素进行调整。结果 该研究包括 1012 名 RA 患者和 1012 名匹配的对照者 （平均年龄 55.9 岁，68.38% 为女性）。风险比 （HRs） 显示，与 1985-1994 年相比，2005-2014 年患有和不患有 RA 的个体的焦虑和抑郁的时间性增加。与对照组相比，RA 患者焦虑 （HR 1.27,95% CI 0.86-1.88） 以及伴随的焦虑和抑郁 （HR 1.49,95% CI 0.96-2.33） 的发生率上升。趋势在血清阳性 RA 患者中最为明显 （焦虑： HR 4.01,95% CI 2.21-7.30）。结论 RA 患者的焦虑和伴随的焦虑和抑郁诊断升高。焦虑症和焦虑症同时发生的发病率的增加表明对这些疾病的认识和诊断不断提高。除了稳定但较高的抑郁症诊断率外，RA 患者现在有证据表明，临床医生应该解决心理健康诊断方面的差距不断扩大。