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Mental disorders among persons with arthritis: results from the World Mental Health Surveys

  • Y. He (a1), M. Zhang (a1), E. H. B. Lin (a2), R. Bruffaerts (a3), J. Posada-Villa (a4), M. C. Angermeyer (a5), D. Levinson (a6), G. de Girolamo (a7), H. Uda (a8), Z. Mneimneh (a9), C. Benjet (a10), R. de Graaf (a11), K. M. Scott (a12), O. Gureje (a13), S. Seedat (a14), J. M. Haro (a15), E. J. Bromet (a16), J. Alonso (a17), V. Kovess (a18), M. von Korff (a2) and R. Kessler (a19)...

Abstract

Background

Prior studies in the USA have reported higher rates of mental disorders among persons with arthritis but no cross-national studies have been conducted. In this study the prevalence of specific mental disorders among persons with arthritis was estimated and their association with arthritis across diverse countries assessed.

Method

The study was a series of cross-sectional population sample surveys. Eighteen population surveys of household-residing adults were carried out in 17 countries in different regions of the world. Most were carried out between 2001 and 2002, but others were completed as late as 2007. Mental disorders were assessed with the World Health Organization (WHO) World Mental Health–Composite International Diagnostic Interview (WMH-CIDI). Arthritis was ascertained by self-report. The association of anxiety disorders, mood disorders and alcohol use disorders with arthritis was assessed, controlling for age and sex. Prevalence rates for specific mental disorders among persons with and without arthritis were calculated and odds ratios (ORs) with 95% confidence intervals were used to estimate the association.

Results

After adjusting for age and sex, specific mood and anxiety disorders occurred among persons with arthritis at higher rates than among persons without arthritis. Alcohol abuse/dependence showed a weaker and less consistent association with arthritis. The pooled estimates of the age- and sex-adjusted ORs were about 1.9 for mood disorders and for anxiety disorders and about 1.5 for alcohol abuse/dependence among persons with versus without arthritis. The pattern of association between specific mood and anxiety disorders and arthritis was similar across countries.

Conclusions

Mood and anxiety disorders occur with greater frequency among persons with arthritis than those without arthritis across diverse countries. The strength of association of specific mood and anxiety disorders with arthritis was generally consistent across disorders and across countries.

Copyright

Corresponding author

*Address for correspondence: Dr Y. He, Shanghai Mental Health Center, 600 Wan Ping Nan Road, Shanghai 200030, China. (Email: heyl2001@yahoo.com.cn)

References

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Ang, DC, Choi, H, Kroenke, K, Wolfe, F (2005). Comorbid depression is an independent risk factor for mortality in patients with rheumatoid arthritis. Journal of Rheumatology 32, 10131019.
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.
Berkanovic, E, Hurwicz, ML (1990). Rheumatoid arthritis and comorbidity. Journal of Rheumatology 17, 888892.
Bird, SM, Cox, D, Farewell, VT, Goldstein, H, Holt, T, Smith, PC (2005). Performance indicators: good, bad, and ugly. Journal of the Royal Statistical Society, Series A 168, 127.
Carmona, L, Ballina, J, Gabriel, R, Laffon, A; EPISER Study Group (2001). The burden of musculoskeletal diseases in the general population of Spain: results from a national survey. Annals of the Rheumatic Diseases 60, 10401045.
CDC (2001). Prevalence of arthritis – United States, 1997. Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report 50, 334336.
Cunningham, LS, Kelsey, JL (1984). Epidemiology of musculoskeletal impairments and associated disability. American Journal of Public Health 74, 574579.
Demyttenaere, K, Bonnewyn, A, Bruffaerts, R, Brugha, T, Graaf, R, Alonso, J (2006). Comorbid painful physical symptoms and depression: prevalence, work loss, and help seeking. Journal of Affective Disorders 92, 185193.
Dickens, C, Jackson, J, Tomenson, B, Hay, E, Creed, F (2003). Association of depression and rheumatoid arthritis. Psychosomatics 44, 209215.
Dunlop, DD, Lyons, JS, Manheim, LM, Song, J, Chang, RW (2004). Arthritis and heart disease as risk factors for major depression: the role of functional limitation. Medical Care 42, 502511.
ESEMeD/MHEDEA 2000 Investigators (2004). Sampling and methods of the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica. Supplementum 420, 820.
Felson, DT, Naimark, A, Anderson, J, Kazis, L, Castelli, W, Meenan, RF (1987). The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis and Rheumatism 30, 914918.
Foley, D, Ancoli-Israel, S, Britz, P, Walsh, J (2004). Sleep disturbances and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America Survey. Journal of Psychosomatic Research 56, 497502.
Guccione, AA, Felson, DT, Anderson, JJ, Anthony, JM, Zhang, Y, Wilson, PW, Kelly-Yayes, M, Wolf, PA, Kreger, BE, Kannel, WB (1994). The effects of specific medical condition on the functional limitations of elders in the Framingham Study. American Journal of Public Health 84, 351358.
Gureje, O, Von Korff, M, Kola, L, Demyttenaere, K, He, YL, Posada-Villa, J, Lepine, JP, Angermeyer, MC, Levinson, D, Girolamo, G, Iwata, N, Karam, A, Guimaraes Borges, GL, Graaf, R, Browne, MO, Stein, DJ, Haro, JM, Bromet, EJ, Kessler, RC, Alonso, J (2007). The relation between multiple pains and mental disorders: results from the World Mental Health Surveys. Pain. Published online: 12 June 2007. doi: 10.1016/j.pain.2007.05.005.
Gureje, O, Von Korff, M, Simon, GE, Grater, R (1998). Persistent pain and wellbeing: a World Health Organization study in primary care. Journal of the American Medical Association 280, 147151.
Haro, JM, Arbabzadeh-Bouchez, S, Brugha, TS, de Girolamo, G, Guyer, ME, Jin, R, Lepine, JP, Mazzi, F, Reneses, B, Vilagut, G, Sampson, NA, Kessler, RC (2006). Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health Surveys. International Journal of Methods in Psychiatric Research 15, 167180.
Helmick, CG, Lawrence, RC, Pollard, RA, Lloyd, E, Heyse, SP (1995). Arthritis and other rheumatic conditions: who is affected now, who will be affected later? Arthritis Care and Research 8, 203211.
John, R, Kerby, DS, Hennessy, CH (2003). Patterns and impact of comorbidity and multimorbidity among community-resident American Indian elders. The Gerontologist 43, 649660.
Kessler, RC, Berglund, P, Chiu, WT, Demler, O, Heeringa, S, Hiripi, E, Jin, R, Pennell, B-P, Walters, EE, Zaslavsky, A, Zheng, H (2004). The US National Comorbidity Survey Replication (NCS-R): design and field procedures. International Journal of Methods in Psychiatric Research 13, 6992.
Kessler, RC, Ormel, J, Demler, O, Stang, PE (2003). Comorbid mental disorders account for the role impairment of commonly occurring chronic physical disorders: results from the National Comorbidity Survey. Journal of Occupational Environment Medicine 45, 12571266.
Kessler, RC, Ustun, TB (2004). The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93121.
Khongsaengdao, B, Louthrenoo, W, Srisurapanont, M (2000). Depression in Thai patients with rheumatoid arthritis. Arthritis Care and Research 83, 743747.
Kriegsman, DMW, Penninx, BWJH, van Eijk, JThM, Boeke, AJP, Deeg, DJH (1996). Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients' self-reports and on determinants of inaccuracy. Journal of Clinical Epidemiology 49, 14071417.
Lawrence, RC, Helmick, CG, Arnett, FC, Deyo, RA, Felson, DT, Giannini, EH, Heyse, SP, Hirsch, R, Hochberg, MC, Hunder, GG, Liang, MH, Pillemer, SR, Steen, VD, Wolfe, F (1998). Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis and Rheumatism 41, 778799.
Lin, EHB, Katon, W, Von Korff, M, Tang, L, Williams, JW, Kroenke, K, Hunkeler, E, Harpole, L, Hegel, M, Arean, P, Hoffing, M, Penna, RD, Langston, C, Unutzer, J (2003). Effect of improving depression care on pain and functional outcomes among older adults with arthritis: a randomized controlled trial. Journal of the American Medical Association 290, 24282434.
Lowe, B, Willand, L, Eich, W, Zipfel, S, Ho, AD, Herzog, W, Fiehn, C (2004). Psychiatric comorbidity and work disability in patients with inflammatory rheumatic diseases. Psychosomatic Medicine 66, 395402.
Mannoni, A, Briganti, MP, Di Bari, M, Ferrucci, L, Costanzo, S, Serni, U, Masotti, G, Marchoinni, N (2003). Epidemiological profile of symptomatic osteoarthritis in older adults: a population based study in Dicomano, Italy. Annals of the Rheumatic Diseases 62, 576578.
Mikkelsen, WM, Dodge, HJ, Duff, IF, Kato, H (1967). Estimates of the prevalence of rheumatic diseases in the population of Tecumseh, Michigan, 1959–60. Journal of Chronic Disease 20, 351369.
Mili, F, Helmick, CG, Zack, MM (2002). Prevalence of arthritis: analysis of data from the US Behavioral Risk Factor Surveillance System, 1996–1999. Journal of Rheumatology 29, 19811988.
National Center for Health Statistics (1994). Evaluation of National Health Interview Survey diagnostic reporting. Vital and Health Statistics Series 2. 120, 1116.
Oliveria, SA, Felson, DT, Reed, JI, Cirillo, PA, Walker, AM (1995). Incidence of symptomatic hand, hip, and knee osteoarthritis among patients in a health maintenance organization. Arthritis and Rheumatism 38, 11341141.
Oslin, DW, Datto, CJ, Kallan, MJ, Katz, IR, Edell, WS, TenHave, T (2002). Association between medical comorbidity and treatment outcomes in late-life depression. Journal of the American Geriatrics Society 50, 823828.
PRC (2003). Morbidity Rate of Chronic Diseases. Ministry of Health, People's Republic of China (www.moh.gov.cn/open/statistics/digest05/s61.htm). Accessed 1 February 2006.
Reginster, JY (2002). The prevalence and burden of arthritis. Rheumatology (Oxford) 41 (Suppl. 1), 36.
Scott, KM, Bruffaerts, R, Tsang, A, Ormel, J, Alonso, J, Angermeyer, MC, Benjet, C, Bromet, E, de Girolamo, G, de Graaf, R, Gasquet, I, Gureje, O, Haro, JM, He, Y, Kessler, RC, Levinson, D, Mneimneh, ZN, Oakley Browne, MA, Posada-Villa, J, Stein, DJ, Takeshima, T, Von Korff, M (2007). Depression-anxiety relationships with chronic physical conditions: results from the World Mental Health Surveys. Journal of Affective Disorders 103, 113120.
Stang, PE, Brandenburg, NA, Lane, MC, Merikangas, KR, Von Knorff, MR, Kessler, RC (2006). Mental and physical comorbid conditions and days in role among persons with arthritis. Psychosomatic Medicine 68, 152158.
SUDAAN (2002). SUDAAN software version 8.0.1. Research Triangle Institute: Research Triangle Park, NC.
Vali, FM, Walkup, J (1998). Combined medical and psychological symptoms: impact on disability and health care utilization of patients with arthritis. Medical Care 36, 10731084.
Van Saase, JL, van Romunde, LK, Cats, A, Vandenbroucke, JP, Valkenburg, HA (1989). Epidemiology of osteoarthritis: Zoetermeer survey. Comparison of radiological osteoarthritis in a Dutch population with that in 10 other populations. Annals of Rheumatic Diseases 48, 271280.
Wittchen, HU (1994). Reliability and validity studies of the WHO Composite International Diagnostic Interview (CIDI): a critical review. Journal of Psychiatric Research 28, 5784.
Wolter, KM (1985). Introduction to Variance Estimation. Springer-Verlag: New York.
Yelin, EH (1995). Musculoskeletal conditions and employment. Arthritis Care and Research 8, 311317.
Yelin, EH, Callahan, LF (1995). The economic cost and social and psychological impact of musculoskeletal conditions. Arthritis and Rheumatism 38, 13511362.
Zhang, YQ, Xu, L, Nevitt, MC, Aliabadi, P, Yu, W, Qin, MW, Lui, LY, Felson, DT (2001). Comparison of the prevalence of knee osteoarthritis between the elderly Chinese population in Beijing and whites in the United States. Arthritis and Rheumatism 44, 20652071.

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