Depressive disorder in rheumatoid arthritis: the more joint’s distressed, the more severely depressed

Introduction: Rheumatoid arthritis (RA) is a chronic debilitating disease with a known association with depression. Disease activity and number of affected joints presumptively influence depression. This study was prepared to determine the prevalence of depressive disorder, its severity, and associated factors in RA patients. Methods: This cross-sectional study was conducted from April-2013 to August-2014. A total of 81 patients with RA were selected by purposive sampling technique from the rheumatology clinic of Shahid-Beheshti hospital, Kashan, Iran. The Severity of depressive disorder was measured by Beck Depression Inventory (BDI), and the diagnosis of depressive disorder was confirmed by a psychiatrist based on DSM-IV-TR. Data was analyzed by chi-square and Fischer’s exact tests. Results: Findings showed that 22.2% of patients had some degree of depression. More than half of them (55.5%) had severe depression, with the rest having moderate (16.7%) and mild (27.8%) severity of depression. There was no significant relationship between depression and demographic factors, and joint deformity. However, the relationship between depression and number of affected joints was statistically significant. Those patients with seven or more affected joints had a higher rate of depression than those with six or less. Conclusion: According to the considerable prevalence of depressive disorder in RA patients in our study, its early screening by BDI and clinical interview is recommended. Those with seven or more affected joints were found to have a higher risk of severe depressive disorder and so need special care.