Key points are not available for this paper at this time.
Background: Mental health disorders are common in people with inflammatory rheumatic diseases (iRMD). A recent meta-analysis shows that iRMDs may be linked to cognitive impairment 1. Objectives: To assess the occurrence of mental health disorders and describe cognitive function in persons with rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), systemic lupus erythemtatosus (SLE) and sjögren`s disease (SjD) in a population-based cohort. Methods: Baseline data from 101,601 participants in the German National Cohort (NAKO, data-freeze 100k data) were included. Participant-reported physician's diagnoses of depression and anxiety, the depression scale of the Patient Health Questionnaire (PHQ-9), the Generalised Anxiety Disorder Symptoms Scale (GAD-7), the depression section of the Mini-International Neuropsychiatric Interview (MINI) and cognitive tests on memory and executive functions were analysed for individuals with iRMD. Results were compared to controls with osteoarthritis (OA), stratified by age and sex. Cognitive function was described for iRMD and controls using a linear regression model to adjust for sex and education (Figure 1). Results: N=3,590 participants (3.5%) had an iRMD (2.3% RA, 0.6% AS, 0.5% PsA, 0.2% SLE, 0.1% SjD) and n=24,030 (24%) OA, see Table 1. Physician's diagnoses of depression (28% vs. 21%), anxiety (16% vs. 11%), a lifetime depressive episode classified by the MINI (7.8% vs. 6.5%), current depressive (PHQ-9>10: 13% vs. 9%) and anxiety symptoms (GAD-7>10: 9.9% vs. 6.4%) were more frequent in iRMDs compared to OA. Depression was most frequent in SLE (34%) and SjD (37%). In all age groups, women were more often affected by mental disorders than men. Compared to OA, those with iRMDs were particularly affected in middle age. Linear regression models showed no differences in neuropsychological test results between iRMD and OA (Figure 1). Conclusion: Individuals with an iRMD often have mental disorders. The survey provides a nationwide assessment of the occurrence based on self-reports and test results of which depression and anxiety but not cognitive dysfunction exceeded the frequency in OA. REFERENCES: 1 Gwinnutt JM, Toyoda T, Barraclough M, Verstappen SMM, Hornberger M, MacGregor A (2023) Cognitive impairment in the immune-mediated inflammatory diseases compared with age-matched controls: Systematic review and meta-regression. Semin Arthritis Rheum 58:152131. DOI:10.1016/j.semarthrit.2022.152131. Acknowledgements: This project was conducted with data from the German National Cohort (NAKO Gesundheitsstudie, www.nako.de). The NAKO is funded by the Federal Ministry of Education and Research (BMBF) project funding reference numbers: 01ER1301A/B/C, 01ER1511D and 01ER1801A/B/C/D, federal states of Germany and the Helmholtz Association, the participating universities and the institutes of the Leibniz Association. Disclosure of Interests: Johanna Callhoff Pfizer, Janssen, Idorsia, Non-personal, unconditional grant for the German National Database of the Arthritis Centres from: Abbvie, AstraZeneca, BMS, Galapagos, GSK, Medac, MSD, Pfizer, UCB, Lilly, Sanofi-Aventis, Klaus Berger: None declared, Anja Strangfeld AbbVie, Biogen, Galapagos, Janssen, Lilly, Pfizer, Takeda, Non-personal, joint and unconditional grant for the RABBIT project from AbbVie, Amgen, Biocon, Bristol Myers Squibb, Celltrion, Fresenius Kabi, Galapagos, Hexal, Lilly, MSD, Pfizer, Samsung Biosepis, Sanofi Aventis, and UCB., Katinka Albrecht: None declared.
Callhoff et al. (Sat,) studied this question.