Last update:
09-Mar-2024

A significant percentage of patients with rheumatoid arthritis (RA) demonstrate comorbid mental disorders, with major depressive disorder (MDD) and generalized anxiety disorder (GAD) being more frequent, while RA is also correlated with increased rates of suicide and concomitant psychiatric symptoms such as insomnia and fatigue. However, a negative correlation exists between schizophrenia and RA, indicating that factors predisposing to the manifestation of the one appear to be protective against the clinical demonstration of the other disease. The main causes of psychiatric disorders that may accompany the manifestation of RA can be attributed to the direct impact of inflammatory processes on CNS or to the pharmaceutical agents used for its treatment (which may have ambiguous effects from a psychiatric point of view), as well as to other clinical manifestations of the disease, given its detrimental effects on patients' quality of life (QoL). At the same time, induced psychological reactions due to the pain caused by RA, to the burden of its physical symptoms and to the change in patient's body image, underline the recognition of inherent immunological and molecular responses to inflammation, fostering the investigation of possible common pathogenetic mechanisms between psychiatric and rheumatic morbidity. Individualized psychiatric interventions not only can alleviate patient's mental and physical pain, but also may modify the progression of the disease itself.

Key words: Depression, Inflammation, Pain, Rheumatoid arthritis, Stress.