Patients with chronic pain suffer dramatic reductions in physical, psychological, and social well being, and their health related quality of life is lower. Anxiety and depressive disorders occur in 20%-25% of patients with rheumatoid arthritis.

The effectiveness of antidepressants for the treatment of major depression is well documented; however, the analgesic properties of this class of medication are under-appreciated.

This study aims to prove magnitude of association between RA and Depression along with independent effect of Fluoxetine on depression and arthritis.

100 socio-demographically matched woman attending a rheumatology clinic with a diagnosis of rheumatoid arthritis as defined by American Rheumatism Association criteria, were approached for the study along with homogenous group of controls. HADS, MADRS and CGI were applied. Both the groups were treated with anti RA drugs along with added antidepressant in depressed RA group.

Strong association between RA and depression was established. Treatment out come of RA was better and earlier in the depressed RA patients who were given antidepressant than non-depressed RA.

All chronic pain conditions warrant psychiatric evaluation to unmask the associated psychiatric disorders as treatment of psychiatric disorders prove to expedite the recovery of physical symptoms as well, thus improving productive life span of an individual with chronic painful conditions.