Date of Award
Master of Public Health (MPH)
School of Public Health
Objective/Purpose: The severity of rheumatoid arthritis and its association with depression and anxiety among a prevalent cohort of American adults has been neither well-researched nor backed by real-world data. This investigation seeks to test the hypothesis that there is an association between disease severity and the aforementioned psychological conditions, both of which are commonly observed in patients with rheumatoid arthritis.
Methods: Real-world data from OM1 Inc.’s rheumatoid arthritis registry (2013-2022) was used for this analysis. Disease severity (low, medium, and high), categorized using disease activity scores, was the main exposure, while depression and anxiety were the study’s two primary outcomes. The adjusted odds ratios were derived using multivariate logistic regression with backwards elimination.
Results: A total of 133,574 patients, categorized into low (N=51,882), medium (N=56,853), and high (N=24,839) disease activity groups, were studied. Disease severity is associated with depression and anxiety at the 0.05 level of statistical significance. In the adjusted model, those with medium disease severity had 1.17 times the odds of having depression compared to those with low disease severity (p<.001, 95% confidence interval [CI]: 1.14, 1.21). Those categorized in the “high” disease severity category had 1.30 times the odds of having depression compared to patients with low disease severity (p<.001, 95% CI: 1.25, 1.34). Similarly, individuals with medium disease severity had 1.15 times the odds of having anxiety compared to those with low disease severity (p<.001, 95% CI: 1.12, 1.19), while those with high disease severity had 1.22 times the odds of having anxiety compared to the referent group (p<.001, 95% CI: 1.18, 1.26).
Discussion: Since RA disease severity is associated with depression and anxiety in this real-world analysis, it may be beneficial to integrate mental health screening in treatment paradigms in order to improve health outcomes, especially for patients with more severe cases of RA.
Ballesteros, Nicole-Anne, "Association Between Rheumatoid Arthritis Severity And Mental Health In A Prevalent Cohort Of American Adults, 2013-2022" (2022). Public Health Theses. 2129.