Beyond rheumatoid arthritis: A meta-analysis of the prevalence of anxiety and depressive disorders in rheumatoid arthritis

Abstract

Background

The prevalence of anxiety and depressive disorders in patients with rheumatoid arthritis (RA) is heterogenous with reports from 2.4 % to 85.2 % and 15 %–73.2 %, respectively. The present study provides meta-analytic current, and lifetime estimates of anxiety and depressive disorders amongst those living with RA.

Method

An online search of PubMed, PsycINFO, CINAHL, and WoS was conducted. Of the 3801 articles identified, 13 and 22 studies were coded for anxiety or depressive disorder prevalence in RA, respectively. Studies were included if they prospectively examined individuals (age >16) with RA, used semi-structured diagnostic interviews, and reported lifetime or current anxiety or depressive disorder comorbidity.

Results

Data were analyzed using a Bayesian multilevel modelling approach, revealing current and lifetime prevalence of anxiety disorders to be 13.5 % CI_{95 %} (9.2–17.3) and 22.2 %, CI_{95 %} (15.9–29.1), respectively. Models also demonstrated the current and lifetime prevalence of depressive disorders to be 17.9 % CI_{95 %} (10.1–27.1) and 32.4 %, CI_{95 %} (18.3–47.6), respectively. Moderator analyses revealed numerically greater rates of GAD and MDD than other anxiety or depressive disorders.

Limitations

There were too few estimates to extensively model several moderators or to conduct exhaustive comparisons of demographic populations requiring greater representation such as males, non-White participants, and people with young adult RA onset.

Conclusions

The prevalence and risk for comorbid anxiety and depressive disorders in RA is extremely high. Routine screening and ongoing monitoring of individuals with RA for comorbid anxiety and depressive disorders is important to support improved prognosis.