Depression and anxiety are linked to a decreased likelihood of achieving sustained minimal disease activity in people with psoriatic arthritis, Canadian researchers report.

A systematic review and meta-analysis published in Clinical Rheumatology shows that anxiety and depression are common among patients with psoriatic arthritis.

Women with a history of depression are more than twice as likely as those without depression to develop systemic lupus erythematosus, shows an analysis of data from the Nurses’ Health Study.

Kuriya B et al. J Rheumatol 2018. doi: 10.3899/jrheum.171195

Advisory Board member Susan Bartlett discusses the prevalence of mental health comorbidities in patients with inflammatory arthritis, and their impact on disease symptoms and quality of life.

Once identified, depression and anxiety are treatable.

Depression and anxiety are significant comorbidities in early rheumatoid arthritis and levels change in line with disease activity, shows research.

More severe structural disease is associated with an increased risk for depression among patients with radiographic knee osteoarthritis, according to study results presented at the EULAR 2018 meeting in Amsterdam, the Netherlands.

More severe structural disease is associated with an increased risk for depression among patients with radiographic knee osteoarthritis, according to study results presented at the EULAR 2018 meeting in Amsterdam, the Netherlands.

Patients with rheumatoid arthritis have an elevated risk for psychiatric disorders, and the presence of depression is associated with a reduced likelihood of achieving a good response to biologic treatment, findings from two studies suggest.

Depression and anxiety are associated with reduced rates of joint remission among patients with rheumatoid arthritis and psoriatic arthritis, researchers report.

There were no between-group differences at either timepoint for health-related quality of life, depression or fatigue.

The rates of nausea, headache, diarrhea, depression, nervousness, and numbness or tingling were also generally higher among patients with PsA versus RA initiating a TNF inhibitor.

There were no differences between the two groups at 12 weeks in WOMAC knee pain, anxiety, depression, stress, fear of movement, or balance confidence.

Study findings suggest that major depressive disorder could be a risk factor for the development of rheumatoid arthritis.

This paper reviews potential biologic mechanisms for the cognitive impairment, depression and fatigue associated with systemic lupus erythematosus (SLE). Summary Patients with SLE frequently report cognitive impairment, fatigue and depression, which have a substantial impact on their quality of life. The immune system and the brain are interlinked via several pathways: within the central nervous system (CNS) between neurons and between neurons and microglia, within the vasculature in various brain regions and within neuroendocrine pathways. Data exists to support a role for adaptive immunity in normal brain function. The choroid plexus, a specialized interface between the brain and the peripheral circulation, acts as a mediator for neuroimmune interactions – an abundance of T cells in this area has been associated with worsening CNS and peripheral disease manifestations in mouse models. Increased levels of peripheral circulating inflammatory cytokines are thought to mediate changes in central cytokine expression, leading to transient alterations in cognitive processes. This may occur in chronic inflammatory states such as in SLE, where organ damage related to immune dysregulation is mediated partly by peripheral circulating cytokines. Idiopathic major depression has been associated with increased circulating levels of cytokines, and increased SLE activity has been linked to increased vulnerability to depression. Central mechanisms that may play a role in the complex interplay between the immune system and cognition involve the cytokines, chemokines and neurotransmitters, with impaired adult neurogenesis also playing a possible role. Autoantibodies present in SLE have also been implicated in cognitive disturbances and mood disorders. Cerebrospinal fluid autoantibody levels have been shown to correlate significantly with neuropsychiatric manifestations. Evidence suggests that the chronic inflammation present in SLE, along with episodes of acute escalation, lead to altered CNS processing, with resultant effects on cognition and mood. Mackay M. Immunol Res  2015;63:26–37. doi:10.1007/s12026-015-8716-3