Treatment for Depression and Health-Related Quality of Life among Adults with Arthritis
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Depression treatment has been proven to relieve depressive symptoms and pain and may therefore improve the health-related quality of life (HRQoL) among adults with arthritis. The objective of the current study was to examine the HRQoL associated with depression treatment among adults with arthritis and depression. A retrospective longitudinal cohort study design using data from the Medical Expenditure Panel Survey (2009–2012) was adopted. The study sample consisted of adults (≥ 21 years) with co-existing arthritis and depression (N = 1692). Depression treatment was categorized into: antidepressants only, psychotherapy with or without antidepressants, and neither antidepressants nor psychotherapy. Multivariable Ordinary Least Square (OLS) regressions, which controlled for observed selection bias with inverse probability treatment weights (IPTW) were built to examine the association between depression treatment categories and the HRQoL scores. The OLS regression controlled for factors in the biological, psychological and social domains that may affect HRQoL. A majority of individuals reported taking antidepressants only (52%), 24.4% reported receiving psychotherapy with or without antidepressants and 23% did not receive either antidepressants or psychotherapy. In multivariable OLS regression with IPTWs, adults using only antidepressants had marginally higher physical component summary scores (beta = 0.96, p value = 0.096) compared to no depression treatment. There were no significant associations between depression categories and mental component summary scores. HRQoL was not affected by depression treatment in adults with coexisting arthritis and depression. Improvement in HRQoL may require a collaborative care approach and such intense care may not be replicated in real-world practice settings.
KeywordsArthritis Depression Depression treatment Health-related quality of life Antidepressants Psychotherapy
Drishti Shah was responsible for developing the initial concept, study design and data analysis section of the study. Drishti Shah and Pragya Rai were responsible for result interpretation and writing the manuscript under Dr. Sambamoorthi’s supervision. Dr. Sambamoorthi and Dr. Dwibedi mentored Drishti and Pragya and worked closely with them to develop the methodology, interpreting the study findings and drafting the manuscript. Dr. Dwibedi provided useful feedback on conceptualizing the study, identifying appropriate methodologies and also helped in editing the final manuscript.
Compliance with Ethical Standards
Conflict of Interest
The opinions expressed in this article are of the authors and do not reflect the views/opinions of any organization. Ms. Drishti Shah declares that she has no conflict of interest. Ms. Pragya Rai declares that she has no conflict of interest. Dr. Nilanjana Dwibedi declares that she has no conflict of interest, and Dr. Usha Sambamoorthi declares that she has no conflict of interest.
Dr. Sambamoorthi received support from NIH/NIGMS Award Number U54GM104942.
The authors have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 1.Wells KB, Stewart, A., Hays, R.D. et al., The functioning and well-being of depressed patients: results from the Medical Outcomes Study. J. Am. Med. Assoc. 262, 916–919. 1989.Google Scholar
- 9.Keller MB MJ, Klein DN, Arnow B, Dunner DL, Gelenberg AJ,et al,. A comparison of nefazodone, the cognitive behavioral-analysis system of psychotherapy, and their combination for the treatment of chronic depression. New England J Med, 342(20):1462–1470. Epub 2000/05/18. 2000.Google Scholar
- 17.Sarzi Puttini P, Cazzola M, Boccassini L, Ciniselli G, Santandrea S, Caruso I et al. A comparison of dothiepin versus placebo in the treatment of pain in rheumatoid arthritis and the association of pain with depression. The Journal of international medical research. 1988;16(5):331–7.CrossRefPubMedGoogle Scholar
- 21.Engel GL. The clinical application of the biopsychosocial model. Am J Psychiatry. 1980;13:535–44.Google Scholar
- 22.National Association of Social Workers. NASW standards for social workpractice in health care settings; 2005 [Washington DC, Available at URL:http://www.socialworkers.org/practice/standards/naswhealthcarestandards.pdf. Accessed 3 June 2013]. 2005.
- 23.Cohen JW MA, Beauregard KM, Cohen SB, Lefkowitz DC, Potter DE, et al.. The Medical Expenditure Panel Survey: a national health information resource. Inquiry. 1996;33:373–89. [PMID: 9031653].
- 27.Murphy LB SJ, Brady TJ, Hootman JM, Chapman DP:. Anxiety and depression among US adults with arthritis: prevalence and correlates. Arthritis Care Res 2012, 64(7):968–976. Epub 2012/05/03.Google Scholar
- 31.Kroenke K BM, Damush TM, Wu J, Hoke S, Sutherland J, et al,. Optimized antidepressant therapy and pain self-management in primary care patients with depression and musculoskeletal pain: a randomized controlled trial. JAMA 2009, 301(20):2099–2110. Epub 2009/05/28.Google Scholar