Researchers at the University of California in San Francisco examined data on 824 clinic visits by 466 rheumatoid arthritis patients and found that 37% were rated as having moderate to severe depression.
But patients who sought treatment at a public hospital clinic, which serves mainly patients from lower socioeconomic groups, were more likely to be depressed. They were also more likely to score higher on tests for depression, compared to patients with the resources to seek help at a university medical center.
Patients treated at a public hospital clinic were also found to have higher disability scores and more active disease symptoms from rheumatoid arthritis.
In the study, the health care settings were used as proxies for socioeconomic status, with the public facility associated with lower socioeconomic status, and the university clinic with higher socioeconomic status in general.
“For the same level of disability, patients with low [socioeconomic status] may be more likely to experience depression,” Mary Margaretten, MD, of UCSF and author of the study, says in a news release.
She says that “detection and documentation of the differing effects of disability on depression between patients of different socioeconomic status can help rheumatologists improve outcomes by initiating appropriate and timely treatment for depression.”
Depression is common in people with rheumatoid arthritis, previous research has shown.
The researchers say they wanted to investigate differences in functional limitations and socioeconomic inequality among rheumatoid arthritis patients.
“There are disparities in both physical and mental health among individuals with low socioeconomic status, and the presence of poor physical functioning exacerbates the disparity in mental health” the authors write. “The psychological effects of disability vary in patients with RA, such that a vulnerable population with functional limitations is at higher risk for depressive symptoms.”
The study is published in the February issue of Arthritis Care & Research.