Arthritis, Anxiety, and Depression: Managing a Common Comorbidity

Anxiety is even more common than depression among arthritis patients, a new study shows. Listen as pain researcher Elizabeth Lin MD probes the implications.

Many people with arthritis also have depression; this has been known for many years. Now it has been established that anxiety is even more common than depression among arthritis patients, in a study published in Arthritis Care & Research by authors from the Centers for Disease Control and Prevention. In this podcast, Dr. Elizabeth Lin (who was not involved with the CDC study, but has focused on comorbid depression and pain for many years) discusses why and how the mental health problem as well as the physical symptoms need to be addressed and resolved.

Dr. Lin is a family medicine physician at Group Health Institute and clinical professor of psychiatry at University of Washington Medical School in Seattle.

Questions:

1. What's new about this study?
2. Could you tell us a little bit about how the study was done and what you think of the results?
3. What do you think doctors should do to assess their arthritis patients for anxiety or depression (or both)?
4. What about the risk of interactions between the two drugs? Isn't it difficult to treat patients with drugs that affect their mood as well as drugs that affect their pain?
5. Do you think that when it comes to treating these mood disorders it would be wise to refer to a mental health professional?
6. What about followup? How often do you recommend that a doctor see a patient who has this kind of comorbidity?

Arthritis, Anxiety, and Depression: Managing a Common Comorbidity

For your reference:

Anxiety is more common than depression among US adults with arthritis
Murphy LG, Sacks JJ, Brady TJ et al Arthritis Care & Research, May 1, 2012 (epub ahead of print)

Generalized Anxiety Disorder 7-item scale (GAD-7)

Patient Health Questionnaire (PHQ-9)

Depression and Osteoarthritis
Lin EH
American Journal of Medicine 2008; 121:S16-S19

Effect of improving depression care on pain and function among older adults with arthritis: A randomized controlled study.
Lin EH, Katon W, Von Korff M, et al
JAMA 2003 Nov 12; 290:2428-34

Pharmacotherapy of pain in depressed older adults.
Unutzer J, Ferrell B, Lin EHB et al
J Am Geriatr Soc. 2004 Nov; 52(11):1916-22.

Arthritis pain and disability: Response to collaborative depressive care.
Lin EHB, Tang L, Katon W, et al
Gen Hospital Psychiatry 2006; 27:482-6