Rheumatoid arthritis (RA) patients are twice as likely to experience depression as their otherwise healthy peers.

Betsy Sleath, University of North Carolina, Chapel Hill, studied 200 RA patients from 4 rheumatology clinics, seeing one of 8 participating physicians. The patient’s doctor visit was audio taped as well as being interviewed after the visit with a questionnaire to measure their mental status.

Approximately, 11% of the patients had moderately severe to severe signs of depression. Those with a greater restriction of normal activity showed increasing levels of depression. Of those patients that showed signs of depression only 20% discussed their concerns of depression with the attending physician.

Sleath feels that a chronic disease, like RA, can greatly impact a patient’s psychosocial well-being. However, the patient’s primary care physician typically does not initiated discussion about depression and if they do it is not addressed to any great degree. She notes that some physicians may not feel comfortable discussing depression with their patients, but they should consider having their office staff administer a brief depression screening before the patient’s visit. Furthermore, Sleath suggest that rheumatologist should be prepared to refer patients to a mental health profession or communicate with the patient’s primary care physician to coordinate a treatment plan.