Depression and subsequent risk for incident rheumatoid arthritis among women
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Objective: To investigate the association of depression with subsequent risk of rheumatoid arthritis (RA) by serologic phenotype. Methods: We performed a cohort study using pooled data from the Nurses’ Health Study (NHS; 1992–2014) and the NHSII (1993–2015). Depression was defined according to the following composite definition: diagnosis by clinician, regular antidepressant use, or a 5‐question Mental Health Inventory score of <60 using time‐updated questionnaires during follow‐up. Incident RA cases met research criteria by medical record review. Information on covariates, including smoking, diet, and body mass index, was obtained using questionnaires. Cox regression estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) for RA risk (overall and by serologic phenotype) according to depression status and adjusted for potential confounders. All analyses included a time separation between assessments of depression and the window for RA risk of at least 4 years to lower the possibility that depressive symptoms due to early RA prior to diagnosis explained any associations. Results: Among 195,358 women, we identified 858 cases of incident RA (65% seropositive) over 3,087,556 person‐years (median 17.9 years per participant). Compared to women without depression, those with depression had multivariable HRs as follows: 1.28 (95% CI 1.10–1.48) for all RA; 1.12 (95% CI 0.93–1.35) for seropositive RA; and 1.63 (95% CI 1.27–2.09) for seronegative RA. When analyzing components of the composite depression exposure variable, regular antidepressant use was not associated with subsequent seropositive RA (HR 1.21 [95% CI 0.97–1.49]) and was associated with seronegative RA (HR 1.75 [95% CI 1.32–2.32]). Conclusion: Indicators of depression, specifically antidepressant use, were associated with subsequent increased risk for seronegative RA, and this finding was not explained by measured lifestyle factors prior to clinical presentation.
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Students from broken families have low confidence in every aspect of life and are weak at handling emotional breakdowns compared to students from complete and happy families.
“Firstly, students from broken families have low confidence in every aspect of life, and they are weak at handling emotional breakdowns compared to students from complete and happy families (55–57).”
From Family and Academic Stress and Their Impact on Students' Depression Level and Academic Performance (2022) · cites this paper as [55]
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- Authors
- Sparks, J. A., Malspeis, S., Hahn, J., Wang, J., Roberts, A. L., Kubzansky, L. D., & Costenbader, K. H.
- Affiliations
- Brigham and Women's Hospital (US)
- Harvard University (US)
- Corresponding author
- Sparks, Jeffrey A.
- Venue
- Arthritis Care & Research
- Publisher
- Wiley
- Published
- 2020-12-30
- Volume
- 73
- Issue
- 1
- Pages
- 78-89
- ISSN
- 0893-7524 (ISSN-L)
- 2151-464X
- 2151-4658
- PMC
- PMC7775283
- OpenAlex
- W3086694282
- Cited by
- 53
- References
- 47
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 6 · 2023: 11 · 2022: 17 · 2021: 9 · 2020: 2
- FWCI
- 7.35
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Arthritis Care & Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (K23 AR069688, K24 AR066109, L30 AR066953, P30 AR070253, P30 AR072577, R01 AR049880, R01 AR057327, R03 AR075886)
- Rheumatology Research Foundation
- National Cancer Institute (U01 CA176726, U01 CA186107)
- Harvard Medical School
- Topics
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Keywords
- depression, rheumatoid arthritis, seronegative rheumatoid arthritis, seropositive rheumatoid arthritis, antidepressant use, women, Mental Health Inventory, lifestyle factors
- MeSH terms
- Adult, Antidepressive Agents, Arthritis, Rheumatoid, Depression, Female, Humans, Middle Aged, Nurses, Risk Factors, Serologic Tests, Time Factors, United States, Incidence, Women's Health, Risk Assessment
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