Comorbidity of Depression and Rheumatoid Arthritis – A Literature Review

Abstract

Introduction and purpose

Rheumatoid arthritis is a chronic inflammatory disease affecting joints, heart, kidneys, and lungs. It is often bilaterally associated with depression, presenting with sleep troubles, fatigue, and chronic pain, inevitably leading to disability and significant worsening of patients' quality of life. This review aims to summarize the current knowledge on the comorbidity of RA and depression, exploring shared etiological factors, challenges in research methodology, and therapeutic approaches.

A brief description of the state of knowledge

Inflammatory mechanisms, including elevated plasma levels of pro-inflammatory cytokines, play a crucial role in both conditions. Biological treatments have shown promise in alleviating depressive symptoms in treatment-resistant depression (TRD). Cognitive behavioral therapy (CBT) and pharmacotherapy, including serotonin-norepinephrine reuptake inhibitors (SNRIs), have proven effective in managing depression in RA patients. In general, it worsens their condition and accelerates disability.

Conclusions

The comorbidity of RA and depression is the most significant among all mental diseases.  Despite known etiology, further studies should focus on standardized methodology, unification of diagnostic criteria, full representation of all social groups, as well as further research on biological drugs and their effectiveness in depression and RA not only as comorbidities, but also separate diseases.