THU0100 Work impairment in rheumatoid arthritis is highly correlated with depression. (12th June 2018)

• Record Type: Journal Article
• Authors: Houssien, A.D.; Galloway, J.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 271
• Page End: 272
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.5395
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Work outcomes are highly relevant in rheumatoid arthritis. Almost a third of people are no longer in employment by 2 years after diagnosis. Remaining in the workforce has positive attributes in terms of health outcome and quality of life. Objectives: We set out to study the relationship between work and depression in rheumatoid arthritis. Methods: We used routinely collected data from a hospital rheumatoid arthritis cohort that has systematically collected longitudinal data on disease measures, mental health, and work impairment. The Work and Social Adjustment Scale was used to estimate work impact, and we used question 2 (scale 0–8, above 6 indicating severe impairment) for analyses. Mood was assessed using the PHQ2. Cross sectional analyses were used to describe the relationship between work impairment and depression, adjusting for disease severity factors. We then analysed the temporal relationship between work impairment and mood. Results: In total 283 patients had data available for analysis. Mean age was 53 years (SD 15), 81% were female, median disease duration 6 years (IQR 0 to 10). 74% were seropositive (RF or CCP), mean baseline DAS28 score 3.8 (SD 1.7), baseline HAQ 1.2 (SD 0.9). At baseline 69% reported no depression, 13% reported some symptoms, 18% had probable major depression. 72% of patients reported some degree of work impairment, 14% reported severe impairment. There was a strong relationship between baseline depressive symptoms and work impairment: coefficient 2.4, 95% CI 1.7 to 3.0, p<0.001. Adjusting for age, gender, DAS28, HAQ: 1.3, 95% CI 0.5 to 2.0, p=0.004. Over time work impairment increased (linear regression coefficient: 0.2 per year 95% CI 0.1 to 0.4), see figure 1. People with baseline low mood had an accelerated worsening of work impairment. Conclusions: Work impairment is highly prevalent in contemporary rheumatoid arthritis patients. It is significantly correlated with mental health, even after adjusting for disease severity factors. Baseline mental health also predicts progression of work impairment. The relationship is likely bidirectional, and future research is justified to evaluate whether mental health interventions could improve work outcomes. Disclosure of Interest: None declared