Arthritis associated with elevated mental health burden
King’s Health Partners research shows people with arthritis are consistently more likely to have depression, increased perceived stress and a range of other mental health conditions.
The study, published in Scientific Reports, investigated the relationship between arthritis and mental health across more than a quarter of a million adults in 46 countries. It demonstrates for the first time, on a multinational scale, that depression subtypes, psychosis spectrum, stress sensitivity, sleep problems and anxiety are increased in people with arthritis. It is also the first study to identify the increased odds of arthritis among people with a diagnosis of psychosis in low- and middle-income countries (LMICs).
The increase in mental health conditions seen among those with arthritis was similar for people in middle-income and low-income countries.
The study was authored by Dr Brendon Stubbs, Head of Physiotherapy at South London and Maudsley NHS Foundation Trust and Research Physiotherapist at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London.
Recent global surveys have shown that chronic musculoskeletal and joint conditions are leading causes of disability, particularly in Western societies. One of the main clusters of chronic musculoskeletal and joint disorders is arthritis, a broad term encompassing osteoarthritis and inflammatory arthritic conditions such as rheumatoid arthritis. The hallmark features of arthritis are pain and discomfort. Unsurprisingly, increasing evidence has demonstrated that arthritis is associated with high levels of disability and a lower quality of life.
Assessing the presence of anxiety and depression in arthritis is important since it is known to predict treatment response in patients. Previous studies conducted in high-income countries show that having a mental health condition in conjunction with arthritis leads to worse pain and poorer treatment outcomes.
The problem is exacerbated in LMICs where people are more likely to undertake more physically demanding jobs. Maintaining good mental and physical health is crucial for their livelihoods and general welfare. However resources to deal with the physical aspects of arthritis or mental health generally are not well established in LMICs.
The paper concludes that understanding the joint burden of a mental health condition coupled with arthritis is important for planning service development in all countries assessed by the study so that appropriate interventions can be provided.
Dr Brendon Stubbs said:
Understanding and treating arthritis in people who also have an associated mental health condition is essential. Comorbid mental health conditions can lead to poor outcomes for patients, decreasing their quality of life and affecting their livelihood.
Integrating mental and physical healthcare is essential, and creating integrated interventions that address arthritis and mental health comorbidities are needed to tackle this considerable burden. Colleagues at King’s Health Partners are already advancing the field in this regard, with Dr Sam Norton conducting some pioneering work by developing an app to improve mental healthcare in people with arthritis.
More research is also required to understand the specific difficulties around the mental health burden of arthritis in LMICs.
King’s Health Partners are committed to joining up mental and physical healthcare, training and research to improve health outcomes for our patients and service users through our mind and body programme.