Strong Mental Health Among Patients with Arthritis, with Esme Fuller-Thomson, PhD, MSW

Findings from a recent study are highlighting exceptional mental health and a lack of psychiatric disorders among patients with arthritis who report living with disabling chronic pain.

Using data from the Canadian Community Health Survey-Mental Health, investigators identified 620 adults with arthritis who reported debilitating chronic pain and completed a secondary analysis examining the prevalence of, and factors associated with, mental health and psychiatric disorders.

Absence of psychiatric disorders in the past year was based on no suicidal ideation, depressive episodes, anxiety disorders, bipolar disorders, nor alcohol or drug dependence. These factors were derived using the World Health Organization’s version of the Composite International Advances in Preventive Medicine Diagnostic Interview and the international Classification of Disease. Complete mental health was based on the absence of psychiatric disorders in the past year, emotional wellbeing, and social and psychological well-being, assessed using the Mental Health Continuum—Short Form.

Among the cohort, 76% of patients were free of psychiatric disorders and 55.6% were in complete mental health. The mean age of those without psychiatric disorders was 62.4 (Standard deviation [SD], 12.8) years, which was significantly higher than participants who had psychiatric disorders (54.7 years; SD, 12.8; P < .001). Similarly, investigators pointed out the mean age of those in complete mental health (61.9 years; SD, 12.8) was significantly higher than those who were not (58.9 years; SD, 13.7; P = .005).

Upon analysis, the odds of not having psychiatric disorders were more than 3-fold greater in individuals in the top 50% of household incomes (odds ratio [OR], 3.67; 95% confidence interval [CI], 1.55-8.68) compared to those in the lowest 10% of household incomes. Those in the highest 50% of household incomes were also 77% more likely to be in a state of complete mental health compared to those in the lowest 10% of household incomes.

Investigators also noted white respondents were more than twice as likely to be in complete mental health (OR, 2.83; 95% CI, 1.48-5.41) compared to racialized respondents. Individuals with a confidant were also more likely to be free of psychiatric disorders (OR, 5.81; 95% CI, 2.36-14.26) and in complete mental health (OR, 6.10; 95% CI, 2.10-17.74) than those without at least 1 confidant. Individuals without sleep problems were more than twice as likely not to have psychiatric disorders (OR, 3.31; 95% CI, 1.76-6.21) and be complete mental health (OR, 2.32; 95% CI, 1.55-3.47).

The editorial team of HCPLive Rheumatology sat down with primary investigator Esme Fuller-Thomson, PhD, MSW, director of the Institute for Life Course and Aging at the University of Toronto, for more insight into the study’s results and their greater implications in clinical practice.

Reference:

Fuller-Thomson E, Marshall DJ, Moses M, et al. Flourishing mental health despite disabling chronic pain: Findings from a nationally representative sample of Canadians with arthritis. PLOS ONE. https://doi.org/10.1371/journal.pone.0291722