Symptoms of rheumatoid arthritis and depression may overlap, and active disease may mask depression. Dobkins and Boire evaluated patients with rheumatoid arthritis for depression. The authors are from McGill University and Universite de Sherbrooke.

A patient with a chronic inflammatory condition such as rheumatoid arthritis is at increased risk for depression.


Clinical findings shared between an inflammatory arthritis and depression include:

(1) fatigue

(2) sleep disturbance

(3) poor appetite


Depression needs to be considered when a patient fails to achieve a complete remission when the joint inflammation is completely under control.


Problems in diagnosis and treatment of depression:

(1) the patient may resist the diagnosis

(2) the patient may not have insurance

(3) treatment resources may not be available

(4) patients have adverse side effects to therapy (weight gain, fatigue)

(5) resistance to taking another medicine


A patient may be more receptive to non-pharmacologic interventions such as exercise.

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