Dr. Brooks said her group is currently working on “integrated non-pharmacological psychotherapy interventions” for the overlapping conditions.
Dr. Romilla Batra, Chief Medical Officer at SCAN Health Plan in Long Beach, California, commented, “The study puts a spotlight on the association of one of the most common causes of pain in older adults and depression.”
“Specifically focusing on arthritis is interesting because realistically it’s probably undertreated and underreported – it’s seen as a fact of life, an inevitable part of aging, so people don’t always report their pain,” she said in an email to Reuters Health. “Getting mental health providers to ask about pain makes great sense. Perhaps the most critical aspect is that they are acknowledging that medical and mental health conditions need to be treated together for the best outcomes.”
“The study wasn’t designed to show causality,” she noted, “and it also doesn’t clarify what type of arthritis they are talking about – there is a difference between osteoarthritis and inflammatory types like rheumatoid arthritis.”
“These diagnoses were self-reported, which introduces a level of uncertainty,” she added. “And, the depression definition was based on the PHQ-9. Many older adults have a type of depression that doesn’t quite meet the criteria, but may still affect mood and function.”
Dr. Michael J. Schrift, Chief of Geriatric and Neuro-psychiatry at Northwestern Memorial Hospital in Chicago, commented by email, “Studies show that when depression is co-occurring with arthritis and the depression is not being addressed, the treatment for arthritis itself can be less effective.”
“Both depression and arthritis affect the brain and the body and likely (have) a bidirectional association,” he told Reuters Health. “Inflammation in arthritis involves not only the affected joint, but also the brain. Also, changes in the brain affect one’s pain perception.”
Reference
- Brooks JM, Titus AJ, Polenick CA, et al. Prevalence rates of arthritis among US older adults with varying degrees of depression: Findingsfrom the 2011 to 2014 National Health and Nutrition Examination Survey. Int J Geriatr Psychiatry. 2018 Sep 19. [Epub ahead of print]
