#ACR24 Abstracts: Mental Health

A Cross-sectional Study of the Association Between Anxiety State and Various Factors in Patients with Rheumatoid Arthritis

 High anxiety in RA patients is associated with increased disease activity, pain, and depression. Managing disease activity from a bio-psycho-social perspective may help reduce anxiety in these patients.

Adverse Childhood Experiences Are Associated with Patient-Reported Outcomes in Adolescents and Young Adults with Systemic Lupus

Study highlights a crucial link between adverse childhood experiences (ACEs) and worse patient-reported outcomes in adolescents and young adults with systemic lupus erythematosus (SLE). This aligns with existing research indicating that ACEs are associated with higher disease activity, depression, and poorer overall health in adults with lupus

Association Between a History of Mental Illness and the Risk of Systemic Autoimmune Rheumatic Diseases: A Nationwide, Population-based Case-control Study

The study investigates the potential association between a history of mental illnesses and the risk of systemic autoimmune rheumatic diseases (SARD), utilizing data from the Taiwanese National Health Insurance Research Database. It included 77,848 SARD patients and 311,392 control subjects. Mental illness was defined based on specific diagnostic codes. The study found that individuals with a history of mental illnesses had a significantly higher risk of developing SARD, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjögren’s syndrome (SS), systemic sclerosis (SSc), and dermatomyositis/polymyositis (DM/PM). The association was strongest for SS and persisted across various definitions of mental illness and exposure periods. The findings suggest that a history of mental illness is a significant risk factor for these autoimmune conditions.

Associations Between Rheumatic Diseases and Mental Health Disorders

The study explores the associations between rheumatic diseases (such as rheumatoid arthritis, systemic lupus erythematosus, psoriatic arthritis, and ankylosing spondylitis) and mental health disorders (anxiety and depression). Using a retrospective case-control design, the study found that patients with these rheumatic diseases had significantly higher odds of experiencing anxiety, depression, and both conditions compared to those without rheumatic diseases. The odds ratios ranged from 6.15 to 9.02 after adjusting for age and sex. 

Impact of Stable Rheumatologic Therapy on Outcomes of Depression in Members with Rheumatoid Arthritis, Psoriatic Arthritis, and Systemic Lupus Erythematosus 

This study examined how stable rheumatologic therapy affects depression outcomes in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and systemic lupus erythematosus (SLE). The research included 3,355 members with RA, PsA, or SLE. Members with stable therapy (no changes) were compared to those with therapy modifications. Key findings showed that patients with stable therapy had lower depression-related care utilization and fewer changes in antidepressant medications. The study concludes that well-controlled RA, PsA, or SLE appear to improve depression outcomes. Overall, the research suggests that maintaining stable rheumatologic therapy can positively impact depression outcomes in these patients.

Key Takeaways for Patients

•  High anxiety in rheumatoid arthritis patients is associated with increased disease activity, pain, and depression, highlighting the need for biopsychosocial management.
• Adverse childhood experiences are linked to worse outcomes in young systemic lupus erythematosus patients, necessitating trauma-informed care and ACE screening.
• A history of mental illness significantly increases the risk of developing systemic autoimmune rheumatic diseases.
• Patients with rheumatic diseases have a higher risk of anxiety and depression, emphasizing the need for routine mental health screenings.
• Maintaining stable rheumatologic therapy improves depression outcomes in patients with rheumatoid arthritis, psoriatic arthritis, and systemic lupus erythematosus.

The ACR Conference 2024 abstracts underscore the complex interplay between mental health and rheumatic diseases. By acknowledging this interplay and providing holistic, patient-centered care, healthcare providers can improve both physical and mental health outcomes for individuals with rheumatic diseases.