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Depression Often Not Discussed in Rheumatology Visits

Rheumatoid arthritis patients with depression symptoms were the ones who brought up the issue in study

WEDNESDAY, Feb. 6 (HealthDay News) -- Patients with rheumatoid arthritis and significant depression often didn't discuss their emotional issues during visits to their rheumatologist, but when they did, it was at the patients' instigation, according to research published in the Feb. 15 issue of Arthritis Care & Research.

Betsy Sleath, Ph.D., of the University of North Carolina at Chapel Hill, and colleagues analyzed data from 200 rheumatoid arthritis patients from four rheumatology clinics. The researchers assessed patients' depression using the Patient Health Questionnaire and checked their audiotaped doctor visits for discussions of depression. Also, the physicians rated the patients' functional status.

Eleven percent of patients had moderately severe to severe depression symptoms, and patients whose physicians rated them as having worse functional status were more likely to have these symptoms (odds ratio 2.23). Only 19 percent of patients with these symptoms discussed depression during their visit, and they started the discussion in each case.

"Many patients with rheumatoid arthritis see their rheumatologist more often than their primary care physician, on average, and some patients with rheumatoid arthritis do not have a primary care physician. For these patients, rheumatologists may become their primary care providers by default, thus stressing the importance of rheumatologists addressing patient issues beyond rheumatoid arthritis such as depression," the authors write.

A co-author has received consultant fees from Alcon Pharmaceuticals.

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