Rheumatology Advance Access originally published online on November 2, 2004
Rheumatology 2005 44(2):241-246; doi:10.1093/rheumatology/keh441
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Rheumatology Vol. 44 No. 2 © British Society for Rheumatology 2004; all rights reserved
Cardiovascular disease and psychological morbidity among rheumatoid arthritis patients
1 University of Birmingham, School of Psychology, Birmingham, 2 Dudley Group of Hospitals NHS Trust, Department of Rheumatology, Dudley, West Midlands, UK, 3 Massey University, Albany Campus, School of Psychology, Auckland, New Zealand, 4 Dudley Group of Hospitals NHS Trust, Department of Cardiology, Dudley, West Midlands, 5 University of Birmingham, School of Health Sciences and 6 University of Birmingham, Department of Rheumatology, School of Medicine, Birmingham, UK.
Correspondence to: G. J. Treharne. E-mail: GJT884{at}bham.ac.uk
Objectives. To examine whether patients with rheumatoid arthritis (RA) with co-morbid cardiovascular disease (CVD) have different psychological morbidity (and psychosocial risk factors for it) compared with RA patients without co-morbid CVD.
Methods. Patients with RA and co-morbid CVD (n = 44; hypertension alone for n = 27) were compared with RA patients without CVD (n = 110). Differences in psychological morbidity (depression and anxiety) and psychosocial risk factors for this (arthritis self-efficacy, acceptance, social support and optimism) were examined while controlling statistically for medical and demographic covariates.
Results. Groups did not differ on RA duration, RA activity, marital status or socioeconomic status, but RA patients with co-morbid CVD were older, less likely to be female and less likely to be in employment than those without CVD. RA patients with co-morbid CVD had significantly higher depression and were more likely to score above cut-offs for depression than RA patients without CVD. No differences existed in anxiety, although anxiety appeared to be more common than depression. Low optimism was identified as a possible psychosocial risk factor for depression.
Conclusions. RA patients with co-morbid CVD have higher depression than RA patients without CVD; low optimism is a potentially modifiable risk factor that may mediate this difference. RA patients with co-morbid CVD may benefit from systematic screening for depression and targeted intervention if necessary.
KEY WORDS: Comorbidity, Depression, Anxiety, Optimism, Work status
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