Depression, inflammation, and pain in patients with rheumatoid arthritis
Article first published online: 30 JUL 2009
Copyright © 2009 by the American College of Rheumatology
Arthritis Care & Research
Volume 61, Issue 8, pages 1018–1024, 15 August 2009
How to Cite
Kojima, M., Kojima, T., Suzuki, S., Oguchi, T., Oba, M., Tsuchiya, H., Sugiura, F., Kanayama, Y., Furukawa, T. A., Tokudome, S. and Ishiguro, N. (2009), Depression, inflammation, and pain in patients with rheumatoid arthritis. Arthritis & Rheumatism, 61: 1018–1024. doi: 10.1002/art.24647
- Issue published online: 30 JUL 2009
- Article first published online: 30 JUL 2009
- Manuscript Accepted: 6 APR 2009
- Manuscript Received: 4 NOV 2008
- Grant in aid for the Encouragement of Young Scientists (B) from the Japan Society for the Promotion of Science. Grant Number: 15790301
An association between depression and inflammation has been suggested. In patients with rheumatoid arthritis (RA), pain is a major symptom associated with depression and inflammation. We examined the independent associations between depression, the inflammation marker C-reactive protein (CRP) level, and pain in patients with RA.
In total, 218 RA outpatients completed self-administered questionnaires, using the Beck Depression Inventory II to measure depressive symptoms and a visual analog scale to quantify their perceived pain. Functional disability and CRP level were also measured.
Depression scores were mildly and positively correlated with the CRP level (r = 0.46, P < 0.001). Both the depression score (standardized β = 0.35, P < 0.001) and the CRP level (standardized β = 0.35, P < 0.001) were significantly associated with pain, even after adjustment for clinical covariates in regression analysis. In logistic analysis, the combined effects on the risk of severe pain (pain score in the upper tertile) increased with depression scores and CRP levels linearly.
Depression severity and inflammation were associated with each other and appeared to have independent effects on perceived pain. Therefore, a clinical approach that takes into account both the body and the mind could have benefits and could enable optimal pain control.