Prevalence of anxiety and depression and the association with self-management behaviour in >12 000 patients with inflammatory rheumatic disease: a cross-sectional nationwide study

Objective To investigate the prevalence of anxiety and depression among patients with inflammatory arthritis (IA) and evaluate the association of these mental health issues with self-management behaviour.Methods In this nationwide cross-sectional study, we analysed data from 12 713 adult Danish pati...

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Main Authors: Bente Glintborg, Mette Aadahl, Annette de Thurah, Bente Appel Esbensen, Sofie Bech Vestergaard, Julie Midtgaard Klausen, Lene Lau, Connie Yilmaz Jantzen, Pernille Fevejle Cromhout
Format: Article
Language:English
Published: BMJ Publishing Group 2024-02-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/10/1/e003412.full
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author Bente Glintborg
Mette Aadahl
Annette de Thurah
Bente Appel Esbensen
Sofie Bech Vestergaard
Julie Midtgaard Klausen
Lene Lau
Connie Yilmaz Jantzen
Pernille Fevejle Cromhout
author_facet Bente Glintborg
Mette Aadahl
Annette de Thurah
Bente Appel Esbensen
Sofie Bech Vestergaard
Julie Midtgaard Klausen
Lene Lau
Connie Yilmaz Jantzen
Pernille Fevejle Cromhout
author_sort Bente Glintborg
collection DOAJ
description Objective To investigate the prevalence of anxiety and depression among patients with inflammatory arthritis (IA) and evaluate the association of these mental health issues with self-management behaviour.Methods In this nationwide cross-sectional study, we analysed data from 12 713 adult Danish patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) or spondyloarthritis (SpA). Patients received an electronic questionnaire covering sociodemographics, self-management behaviour and mental health status. Questionnaire data were linked to clinical data from the Danish Rheumatology database (DANBIO) and the Danish National Patient Registry. The prevalence of anxiety and depression (by the Hospital Anxiety and Depression Scale for Anxiety (HADS-A) and Depression (HADS-D)) was estimated separately for RA/PsA/SpA. The association between mental health status and low self-management behaviour (adherence to treatment, health activation and physical activity) was estimated using multivariable logistic regression, adjusting for age, sex, educational level and comorbidity.Results The prevalence of anxiety (HADS-A≥8) was highest for patients with SpA (34.5% (95% CI 32.4% to 36.6%)) and lowest for patients with RA (22.1% (95% CI 21.2% to 23.0%)), it was higher for women, younger (<55 years) and recently diagnosed (<3 years) patients and those with basic education. Similar prevalence estimates were found for depression. Across diagnoses, the clinically relevant symptoms of anxiety and depression (HADS≥8) were significantly associated with low self-management behaviour.Conclusion Patients with IA showed substantial levels of anxiety and depression. A statistically significant association between anxiety and depression and low self-management behaviour was identified. These findings call for a systematic approach to identifying mental health issues in patients with IA.
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spelling doaj-art-54d6d5126e2e4e528b539a2231ab311c2025-08-20T03:11:52ZengBMJ Publishing GroupRMD Open2056-59332024-02-0110110.1136/rmdopen-2023-003412Prevalence of anxiety and depression and the association with self-management behaviour in >12 000 patients with inflammatory rheumatic disease: a cross-sectional nationwide studyBente Glintborg0Mette Aadahl1Annette de Thurah2Bente Appel Esbensen3Sofie Bech Vestergaard4Julie Midtgaard Klausen5Lene Lau6Connie Yilmaz Jantzen7Pernille Fevejle Cromhout8DANBIO, The Danish Rheumatologic Biobank and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark8 Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark2 Department of Clinical Medicine, Aarhus University, Aarhus, DenmarkDepartment of Clinical Medicine, University of Copenhagen, Kobenhavn, DenmarkDepartment of Rheumatology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, DenmarkPatient Research Partner, Aarhus, DenmarkPatient Research Partner, London, UKNovo Nordisk A/S, Søborg, DenmarkObjective To investigate the prevalence of anxiety and depression among patients with inflammatory arthritis (IA) and evaluate the association of these mental health issues with self-management behaviour.Methods In this nationwide cross-sectional study, we analysed data from 12 713 adult Danish patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) or spondyloarthritis (SpA). Patients received an electronic questionnaire covering sociodemographics, self-management behaviour and mental health status. Questionnaire data were linked to clinical data from the Danish Rheumatology database (DANBIO) and the Danish National Patient Registry. The prevalence of anxiety and depression (by the Hospital Anxiety and Depression Scale for Anxiety (HADS-A) and Depression (HADS-D)) was estimated separately for RA/PsA/SpA. The association between mental health status and low self-management behaviour (adherence to treatment, health activation and physical activity) was estimated using multivariable logistic regression, adjusting for age, sex, educational level and comorbidity.Results The prevalence of anxiety (HADS-A≥8) was highest for patients with SpA (34.5% (95% CI 32.4% to 36.6%)) and lowest for patients with RA (22.1% (95% CI 21.2% to 23.0%)), it was higher for women, younger (<55 years) and recently diagnosed (<3 years) patients and those with basic education. Similar prevalence estimates were found for depression. Across diagnoses, the clinically relevant symptoms of anxiety and depression (HADS≥8) were significantly associated with low self-management behaviour.Conclusion Patients with IA showed substantial levels of anxiety and depression. A statistically significant association between anxiety and depression and low self-management behaviour was identified. These findings call for a systematic approach to identifying mental health issues in patients with IA.https://rmdopen.bmj.com/content/10/1/e003412.full
spellingShingle Bente Glintborg
Mette Aadahl
Annette de Thurah
Bente Appel Esbensen
Sofie Bech Vestergaard
Julie Midtgaard Klausen
Lene Lau
Connie Yilmaz Jantzen
Pernille Fevejle Cromhout
Prevalence of anxiety and depression and the association with self-management behaviour in >12 000 patients with inflammatory rheumatic disease: a cross-sectional nationwide study
RMD Open
title Prevalence of anxiety and depression and the association with self-management behaviour in >12 000 patients with inflammatory rheumatic disease: a cross-sectional nationwide study
title_full Prevalence of anxiety and depression and the association with self-management behaviour in >12 000 patients with inflammatory rheumatic disease: a cross-sectional nationwide study
title_fullStr Prevalence of anxiety and depression and the association with self-management behaviour in >12 000 patients with inflammatory rheumatic disease: a cross-sectional nationwide study
title_full_unstemmed Prevalence of anxiety and depression and the association with self-management behaviour in >12 000 patients with inflammatory rheumatic disease: a cross-sectional nationwide study
title_short Prevalence of anxiety and depression and the association with self-management behaviour in >12 000 patients with inflammatory rheumatic disease: a cross-sectional nationwide study
title_sort prevalence of anxiety and depression and the association with self management behaviour in 12 000 patients with inflammatory rheumatic disease a cross sectional nationwide study
url https://rmdopen.bmj.com/content/10/1/e003412.full
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