The association between arthritis and psychiatric disorders; results from a longitudinal population-based study

van 't Land, Hedda; Verdurmen, Jacqueline; ten Have, Margreet; van Dorsselaer, Saskia; Beekman, Aartjan; de Graaf, Ron

doi:10.1016/j.jpsychores.2009.05.011

« Previous Next »Journal of Psychosomatic Research
Volume 68, Issue 2 , Pages 187-193, February 2010

The association between arthritis and psychiatric disorders; results from a longitudinal population-based study

Hedda van 't Land
- Netherlands Institute of Mental Health and Addiction, P.O. Box 725, Utrecht, The Netherlands
- Corresponding author. Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS Utrecht, The Netherlands. Tel.: +31 30 2959262.
Jacqueline Verdurmen
- Netherlands Institute of Mental Health and Addiction, P.O. Box 725, Utrecht, The Netherlands
Margreet ten Have
- Netherlands Institute of Mental Health and Addiction, P.O. Box 725, Utrecht, The Netherlands
Saskia van Dorsselaer
- Netherlands Institute of Mental Health and Addiction, P.O. Box 725, Utrecht, The Netherlands
Aartjan Beekman
- VU University Amsterdam and GGZ Buitenamstel
Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, P.O. Box 725, Utrecht, The Netherlands

Received 16 September 2008; received in revised form 19 March 2009; accepted 20 May 2009. published online 05 October 2009.

Abstract

Background

To disentangle cross-sectionally and longitudinally the relationship between arthritis and psychiatric disorders, and to examine the relationship between age and incidence of (1) any psychiatric disorder among respondents with and without arthritis and (2) arthritis among respondents with and without any psychiatric disorder.

Methods

Data are from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a nationally representative household survey with repeated measurements in 1996, 1997 and 1999. Self-report was used to ascertain arthritis. Psychiatric and substance use disorders were diagnosed with the WHO Composite International Diagnostic Interview.

Results

Regarding the cross-sectional results, it was found that the strength of the association of arthritis with mood and anxiety disorders was similar [odds ratio (OR)=1.48, 95% confidence interval (CI)=1.09–1.99 and OR=1.42, 95% CI=1.11–1.81, respectively]. The longitudinal results showed that preexisting arthritis elevated the risk of developing any mood disorder (OR=1.94, 95% CI=1.23–3.07), whereas having any mood or any anxiety disorder did not predict new-onset arthritis. The incidence of any psychiatric disorder was significantly higher among younger persons (<45 years) with arthritis, compared to others in the same age category without arthritis.

Conclusions

Arthritis is associated with psychiatric disorders. The temporal relationship points to one direction: arthritis predicts new onset of psychiatric disorder (mood disorder) instead of the reverse. Especially younger people (<45 years) with arthritis are at risk of developing a psychiatric disorder. Screening and simultaneous treatment of comorbid mood disorder and arthritis are recommended as part of routine in primary care.

Abbreviations: NEMESIS, Netherlands Mental Health Survey and Incidence Study, WHO, World Health Organization, CIDI, Composite International Diagnostic Interview

Keywords: Arthritis, Psychiatric disorders, Comorbidity, Temporal relationship