The function and related factors between depression, anxiety and rheumatoid arthritis / 中华风湿病学杂志

ABSTRACT

Objective To survey the function and relation of cytokine interleukin-6 (IL-6) between depression,anxiety and rheumatoid arthritis (RA).Methods One hundred and twenty-one patients with RA were investigated.All of them were assessed by Hamihon Depression Rating Scale and Hamihon Anxiety Rating Scale.Results ① The rate of depression in RA patients was 44.6％,and the rate of anxiety was 32.2％,the rate of depression combined anxiety in RA patients was 30.6％.② Social factorsUnemployment [14 cases (26.4％) vs8 cases (11.9％),x2=4.14] and education [41 cases (83.7％) vs 37 cases (58.7％),x2=8.11]was significantly different between depression and non-depression patients (P＜0.05).Age,unemployment and education was significantly different between anxiety patients and non-anxiety patients (P＜0.05).③ Clinical factorstender joint count,swollen joint count,disease activity score (DAS)28,health assessment questionnaire (HAQ),VAS,function of joint and C-reactive protein (CRP) was significantly different between depression patients and non-depression patients [6(2,21) vs 1(0,14);4(1,11) vs 2(0,8);24.0(2.5,36.25) vs 2.5(0,19.5);5(3,9) vs 4(0,7);89.8％ vs 9.7％;37.63(13.25,70.75) vs 11.29(2.05,36.78)] (P＜0.05).And anxiety patients and non-anxiety patients had the same results [6(3,25) vs 2(0,14);6(1.5,12) vs 2(0,7.25);25(5,36) vs 3(0,25);8(5,10) vs 5(1.75,7);91.4％ vs 64.5％;33.4(11.0,63.0) vs 16.8(2.5,54.3)](P＜0.05).④ CytokineIL-6 was significantly different between depression patients and non-depression patients (P＜0.05).JAK-2,JAK-3,Signal transducer and activator of transcription (STAT)-3,matrix Metalloproteinases (MMP)-3,MMP-13 were not different between depression patients and non-depression patients (P＞0.05).IL-6,JAK-2,JAK-3,STAT-3,MMP-3,MMP-13 were not different between anxiety patients and non-anxiety patients (P＞0.05).⑤ Correlation analysis:Education level was negatively related with the severity of depression (r=0.288,P＜0.05).Tender joint count,swollen joint count,DAS28,HAQ,VAS,function of joint,erythrocyte sedimentation rate (ESR),CRP,IL-6 was positively related with the severity of depression (r=0.348,0.268,0.481,0.318,0.381,0.417,0.397,0.311,0.249;P＜0.05).Education level was negatively related with the severity of anxiety.Tender joint count,swollen joint count (r=-0.244,P＜0.05),DAS28,HAQ,VAS,function of joint,ESR,CRP was positively related with the severity of depression (r=0.282,0.261,0.381,0.284,0.284,0.299,0.263,0.178;all P＜0.05).⑥ Risk factorsIL-6 was the only risk factor in RA patients with depression.Conclusion The rate of depression and anxiety in RA is 44.6％.Depression and anxiety is related with disease activity,pain and HAQ.IL-6 is a high risk factor that makes patients prone to develop depression in RA patients.