Anxiety and depression are common psychological problems in rheumatic diseases. Depression is estimated to be prevalent in more than 20% of cases of rheumatoid arthritis. Nearly 80% of patients with fibromyalgia have associated anxiety and depression. Osteoarthritis, systemic lupus erythematosus, and most other chronic rheumatological diseases have associated psychological features. Psychosocial stress is one of the factors responsible for disease onset as well as disease flares. Females and patients with lower socioeconomic and educational status appear to be more prone to develop psychological problems. Although sadness, irritability, and pessimism can be considered normal psychological reactions to any chronic illness, their persistence for prolonged periods indicates a psychological illness. Depression and anxiety can increase pain as well as disease severity and disability. Various factors such as physical appearance, a decline in functional ability, social stress, social isolation, and dependence on drugs to control symptoms lead to psychological stress. Family problems and financial stress aggravate the situation.
Children with arthritis, too, manifest features of depression, especially when parents are distressed. Improved diagnosis and treatment of rheumatologic disorders can reduce this psychological stress. Identification and concurrent therapy of psychological problems is an essential part of the management of chronic diseases. Collaborative care from a psychiatrist may be warranted in such situations. In addition, training in coping, adaptation, and stress management skills, relaxation techniques (Yoga, biofeedback), exercise, and cognitive-behavioral therapies can considerably improve the quality of life in patients with rheumatological diseases. You can quickly evaluate your level of anxiety or depression by answering 14 questions in the scoring sheet of the Hospital Anxiety and Depression Scale (HADS). You have a problem if your score is more than 11, and if so, you need to take some measures against it.