Title"Associations of Rheumatoid Arthritis and Depressive Symptoms over Time: Are there Differences by Education, Race/Ethnicity, and Gender?"
OBJECTIVE To examine associations between changes in Rheumatoid Arthritis (RA) symptoms and depressive symptoms, adjusted for other time-varying characteristics, and to test if these associations differed by education, race/ethnicity, or gender.
METHODS Data from the 1988-98 United States National Rheumatoid Arthritis Study were analyzed (n = 854). Time-varying covariates included year of the study, pain, functional ability, household work disability, parental status, marital status, employment status, and social support. The time-invariant covariates included years since diagnosis, education, race/ethnicity, and gender. Multivariate multilevel-model analyses were used to estimate associations within people over time.
RESULTS People with RA experience considerable change in depressive symptoms, pain, functional disability and household work disability over the study period. Depressive symptoms were driven more by differences between people compared to changes within people over time. Findings show patients experienced increases in depressive symptoms over the study period. The rate of change in depressive symptoms did not differ by education, race/ethnicity, nor gender. Times of worse pain, functional disability, and household disability were associated with worse depressive symptoms. The association of functional disability and depressive symptoms was stronger for men than women.
CONCLUSION Increases in pain and disability were associated with worse depressive symptoms, adjusted for co-variates. It is important to monitor and treat both mental and physical health symptoms. Future research efforts should focus on collecting data reflecting the educational, gender, and racial-ethnic diversity of people with RA.