EDITORIAL - Exploring the link between depression and inflammation and pain in RA

[Guest guest]

Exploring the Link Between Depression and Inflammation and Pain in

Rheumatoid Arthritis

Deane, MD

Posted: 11 Jan 2010

Kojima M, Kojima T, Suzuki S, et al

Arthritis Rheum. 2009;61:1018-1024

Study Summary

Multiple studies suggest a link between inflammation and

depression.[1,2] Understanding that relationship may lead to improved

treatment strategies for patients with inflammatory diseases,

particularly autoimmune diseases.[2]

Kojima and colleagues studied the relationship between inflammation

(C-reactive protein [CRP]) and depression (Beck Depression Inventory

II, Japanese translation) and pain (visual analog scale) in a

cross-sectional analysis of 218 patients with rheumatoid arthritis

(RA) recruited from a Japanese academic rheumatology clinic. They

found a mild but statistically significant positive association

between depression index scores and elevated CRP levels. In addition,

elevated depression scores and CRP levels were independently

associated with increased pain scores. The study authors concluded

that the severity of depression and inflammation are related, with

each having an independent effect on patient-reported pain.

Viewpoint

The relationship between inflammation and pain (and pain perception)

and depression has been explored in multiple studies, with roles

played by central and peripheral nervous system pain processing,

hypothalamic-pituitary-adrenal axis, and psychosocial factors.[1-5] As

such, it is not surprising that these study authors found a

significant relationship between inflammation and pain and depression

in patients with RA. Although we need additional studies to understand

the specific mechanisms involved, the findings of Kojima and

colleagues eventually may have applicability to the clinical treatment

of RA.

*************************************************

Read the full editorial here:

http://www.medscape.com/viewarticle/714100

Not an MD