When you’re struggling to perform everyday tasks due to aching, painful joints, it’s no surprise that your mood will suffer. Data shows that rates of depression and anxiety can be between two and ten times greater than the rates of the general population, depending on the type of arthritis you’re suffering from.
A new study conducted by the University of Maryland in the US and presented at the recent Annual Congress of the European League against Rheumatism, claimed that depression and its side-effects was becoming a stronger factor in the cause and treatment of knee OA.
According to the study, which evaluated 1,652 patients with knee OA but who were below the screening threshold for probable depression, the chances of developing depression can rise to 20% – double that of the general population. Not only that, but depression in knee arthritis is associated with a lower quality of life, a higher mortality rate, and a greater reliance on healthcare.
The knock-on effects of knee arthritis
After assessing OA disease severity at baseline and on three annual follow-up visits – where they examined patients for minimum joint space width, 20-metre gait speed and measuring pain levels on a pain subscale of the WOMAC Index – the research team focussed upon the risks of the onset of depression amongst the study group. Their findings concluded that greater structural disease severity and decreased physical performance are associated with a statistically significant increased risk of experiencing depression.
Knee arthritis and depression link
The two diseases become enmeshed closely; anxiety and depression can lower the pain threshold and chronic pain is known to aggravate anxiety and depression. Inflammation associated with knee osteoarthritis also plays a role: in a 2016 study published in The Journal of Clinical Psychiatry, over 10,000 patient cases were reviewed and those displaying the symptoms of depression were found to have levels of a particular inflammation marker 31% higher than those with no depressive symptoms.
Furthermore, those suffering from arthritis and depression typically find physical activity and normal function becomes limited and often struggle to follow treatment programmes and therefore are at risk of developing further health problems.
It’s the little things that count
This factor was clearly demonstrated by another study conducted in Japan earlier this year, which examined the link between knee pain and function and depressive symptoms – but this time zeroed in on an older sample group (573 adults aged over 65) and the activities which depressed them the most. The study, conducted by Tokyo’s Keio University School of Medicine, discovered that the most problematic symptoms were pain at night while in bed, difficulty getting in and out of a car, and difficulty in putting on (and taking off) socks. Again, it’s clear that being encumbered by pain and difficulty while performing the most mundane tasks – things that younger people take for granted – are more of a factor than losing the ability to run or climb.
As well as the personal effects of depression on the general population, we’re also becoming more aware of the detriment it has on the economy. It has been estimated that depression costs the UK economy 15.8 work hours per annum, with an estimated 21% of all sick days in the UK are caused by workplace stress. The NHS prescribed a record number of antidepressants last year – over double the amount it dispensed a decade ago.
The importance of treating knee osteoarthritis effectively, whether through the management of symptoms or surgical intervention in the form of knee replacement surgery, is essential for preserving quality of life.