Objectives To investigate the association between depression and anxiety and the inability to achieve remission in rheumatoid arthritis(RA) and psoriatic arthritis(PsA) patients. In addition, the association between depressive and anxiety symptoms and disease activity components were explored. Methods 400 RA and 367 PsA patients from the tREACH and DEPAR were included, respectively. Patients had a possible depression or anxiety disorder if they scored >7 on the Hospital Anxiety and Depression Scale(HADS). Remission was defined as DAS44<1.6 in RA and DAPSA≤4 in PsA. Mixed models were used to assess the association between depression/anxiety, at any timepoint during 2 years, and remission during 2 years, and to explore which disease activity components are most influenced by depression/anxiety. Results At baseline, 20% of RA patients had a possible depression and 30% a possible anxiety disorder. In PsA this was 18% and 23%. After adjustment for concurrent anxiety symptoms depression was associated with a lower odds of achieving remission during 2 years of follow-up (OR 0.45(95%CI 0.25-0.80) for RA and OR 0.24(95%CI 0.08-0.71) for PsA). Anxiety was not associated with remission after adjustment for concurrent depression symptoms. The presence of depression/anxiety was associated with higher tender joint count, worse general health, more pain and slightly elevated inflammation markers, but not with more swollen joints in both RA and PsA. Conclusion The presence of depressive symptoms in RA and PsA patients at baseline or during follow-up was associated with a lower likelihood of achieving remission. Healthcare professionals should, therefore, be aware of symptoms of depression.

中文翻译：

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类风湿性关节炎和银屑病关节炎抑郁和焦虑与无法缓解之间的关联


目的 探讨类风湿关节炎 （RA） 和银屑病关节炎 （PsA） 患者抑郁焦虑与无法达到缓解的关系。此外，还探讨了抑郁和焦虑症状与疾病活动成分之间的关联。方法 分别纳入 400 例来自 tREACH 和 DEPAR 的 RA 和 367 例 PsA 患者。如果患者在医院焦虑和抑郁量表 （HADS） 上得分 >7，则可能患有抑郁症或焦虑症。缓解定义为 RA 中 DAS44<1.6 和 PsA 中 DAPSA≤4。混合模型用于评估 2 年内任何时间点的抑郁/焦虑与 2 年缓解之间的关联，并探讨哪些疾病活动成分受抑郁/焦虑的影响最大。结果 基线时，20% 的 RA 患者可能患有抑郁症，30% 的患者可能患有焦虑障碍。在 PsA 中，分别为 18% 和 23%。在调整并发焦虑症状后，抑郁与 2 年随访期间实现缓解的几率较低相关 （RA 的 OR 0.45 （95% CI 0.25-0.80） 和 PsA 的 OR 0.24 （95% CI 0.08-0.71）。在调整并发抑郁症状后，焦虑与缓解无关。抑郁/焦虑的存在与较高的压痛关节数量、较差的总体健康状况、更多的疼痛和略微升高的炎症标志物有关，但与 RA 和 PsA 中关节肿胀的增加无关。结论 RA 和 PsA 患者在基线或随访期间出现抑郁症状与实现缓解的可能性较低相关。因此，医疗保健专业人员应该了解抑郁症的症状。