Depression with osteoarthritis: Life events and coping factors increase risk

Sale JE, Gignac M, Hawker G, University of Toronto. The relationship between disease symptoms, life events, coping and treatment, and depression among older adults with osteoarthritis. J Rheumatol. 2008;35:335-342.

Older patients who have osteoarthritis (OA) are at high risk for clinical depression. Pain, fatigue, negative stressful life events, coping behavior, and coping efficacy all may be factors.

Sale and associates conducted a 5-year prospective study of older persons with hip or knee OA; 1227 persons (mean age, 75.1 years) provided data on demographics, arthritis severity, comorbidities, stressful life events, coping behavior and efficacy, and treatments for OA or depression.The Centre for Epidemiologic Studies Depression (CES-D) scale was used to measure the frequency of depressive symptoms.

Participants generally experienced moderate levels of pain, physical restrictions, and fatigue. Most reported at least 1 other chronic health condition (eg, back or neck problems) and 1 major negative event in the past year (eg, illness or injury). Perceived coping efficacy was somewhat high. The mean CES-D score was 9.4 (21.3% scored 16 or higher, indicating depressed mood). A higher level of depressed mood was significantly associated with female sex, greater pain and fatigue, negative stressful life events, more (unsuccessful) coping behaviors, and receiving treatment for depression.

The authors noted that more research is needed to examine depression and the use of pain medication and to evaluate how coping factors influence disease and mood.