Antidepressants administration in rheumatoid arthritiswith comorbid depression

Objective. To study comorbid depression influence on course of rheumatoid arthritis (RA)and antidepressants efficacy in such pts. Material and methods. 70 pts with RA (all women) fulfilled the 1987 ACR criteria with comorbid depression disturbances were included. 30 from them received course of treatment with antidepressants (main group). 20 refused proposed therapy (main control group). 20 RA pts without depression were included in an additional control group which was also followed up. Hamilton scales of depression and anxiety were used. Results. Baseline clinical measures did not significantly differ between study groups. Antidepressants application in main group pts was accompanied by significant improvement of tender and swollen joint count, morning stiffness duration, pain intensity (score),functional disability index (FDI) after 3 months (<0,001,<0,001, <0,01, <0,001,<0,001). This improvement further increased to sixth month of follow up. Comparison of main and additional control groups showed better outcome in the absence of comorbid depression and its negative influence on results of treatment. Conclusion. Effective treatment of depression with modern antidepressants (selective inhibitors of reverse serotonin capture) in pts with RA improves clinical course of the disease, its prognosis and pts quality of life

OSTEOARTHRITIS AND DEPRESSION

The review considers the problem of comorbidity of osteoarthritis (OA) and depression. The latter in OA patients is shown to be commonly a component of the well-known triad of pain – depression – sleep disorders, frequently determining the functional abilities and quality of life. The presence of anxiety and depression may increase the risk for poor outcomes of arthroplasty. Environmental stressors in patients require a biopsychosocial approach, by determining the possibilities of drug and non-drug treatment. However, despite the relatively large number of works dedicated to the problem of depression in patients with OA, there are many unsolved questions regarding both its role in the development of the disease and approaches to therapy