Withers Mellissa H, Gonzalez Louella T, Karpouzas George A
Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Harbor-UCLA Medical Center, Torrance, CA, USA.
Rheumatol Ther. 2017 Dec;4(2):281-291. doi: 10.1007/s40744-017-0072-4. Epub 2017 Aug 16.
Patients with rheumatoid arthritis (RA) suffer from high rates of depression but depression often remains undiagnosed and untreated among RA patients. Because of its high prevalence and its profound impact on functional disability and health-related quality of life, prompt recognition and management of comorbid depression is urgently needed in patients with RA. Rheumatologists face the challenge of addressing depression in their clinical interactions with patients. The purpose of this paper is to present the prevalence of comorbid depression in RA, to delineate the consequences of depression among RA patients, to discuss the barriers to the identification of depression among RA patients, and to outline a set of recommendations to identify and treat comorbid depression that could be implemented within the rheumatology clinic setting. A comprehensive approach to the management of both physical and mental health needs of RA patients can aid in improving patient overall quality of life. New clinical protocols should be developed to include routine depression screening as part of the rheumatology visit. Patient education to address misconceptions, knowledge gaps, and destigmatize depression is also recommended. More counseling resources, including emotional support groups, are necessary to provide treatment for those suffering from depression. Such interventions could help mitigate disability, improve quality of life, patient function, and overall satisfaction.
类风湿关节炎（RA）患者中抑郁症发病率很高，但在RA患者中抑郁症往往仍未得到诊断和治疗。由于其高患病率及其对功能残疾和健康相关生活质量的深远影响，RA患者迫切需要及时识别和管理共病抑郁症。风湿病学家在与患者的临床互动中面临着应对抑郁症的挑战。本文的目的是介绍RA中共病抑郁症的患病率，描述RA患者中抑郁症的后果，讨论RA患者中抑郁症识别的障碍，并概述一套可在风湿病门诊环境中实施的识别和治疗共病抑郁症的建议。一种全面管理RA患者身心健康需求的方法有助于提高患者的整体生活质量。应制定新的临床方案，将常规抑郁症筛查纳入风湿病就诊的一部分。还建议开展患者教育，以解决误解、知识差距并消除对抑郁症的污名化。需要更多的咨询资源，包括情感支持小组，为抑郁症患者提供治疗。此类干预措施有助于减轻残疾、改善生活质量、患者功能和总体满意度。
