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While it’s easy to understand why many people who live with a chronic physical ailment become depressed, research has shown that the relationship often goes both ways. People who are depressed are also more likely to later develop a physical disease. Research has shown this to be true for lupus, inflammatory bowel disease, and psoriasis. Now a new study finds that it also applies to rheumatoid arthritis (RA).

According to the study, which was presented at the 2019 American College of Rheumatology/Association of Rheumatology Professionals Annual Meeting in Atlanta, women who had been diagnosed with depression were significantly more likely to be diagnosed with RA at least four years later.

This finding was based on an analysis of data taken from the Nurses’ Health Study and the Nurses’ Health Study II, which provided researchers with information on nearly 195,000 women. More research is needed, but widespread inflammation may be the connecting factor between depression and autoimmune conditions including RA.

Interestingly, this particular study found a connection between depression and the risk of only seronegative RA.

Most people with RA are seropositive, which means that they have high levels of specific autoimmune antibodies (rheumatoid factor and/or anti-cyclic citrullinated peptide) in their blood. Seronegative patients do not have these antibodies, although some people eventually develop them. Both seropositive and seronegative rheumatoid arthritis patients experience symptoms like joint pain, fatigue, and fevers, though experts are still investigating how the presence or lack of antibodies might influence the course of the disease.

“Depression was strongly associated with risk for incident seronegative RA, independent of potential confounders including smoking, dietary intake, body mass index, physical activity, and menopause,” the authors wrote.

More research will be needed to determine why depression was tied to seronegative but not seropositive RA.

“This is interesting and contributes to knowledge of differences between these two dominant subtypes of rheumatoid disease,” Mayo Clinic rheumatologist John Davis, III, MD, told CreakyJoints. This knowledge can help doctors and researchers better understand the differences in what causes seronegative versus seropositive RA, “which could improve treatment options,” Dr. Davis says.

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Keep Reading

Depression: Not an Inflammatory Disease, but Inflammation Plays a Huge Role. American Journal of Managed Care. Published October 27, 2018.

Sparks J, et al. Depression and Subsequent Risk for Incident Seronegative Rheumatoid Arthritis Among Women [abstract]. Arthritis & Rheumatology. 2019.

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