LAUSR

Depression is a mental health condition that affects many individuals. When compounded by an autoimmune condition like rheumatoid arthritis, there can be harmful consequences. In this article, we explored if depression modified the connection between rheumatoid arthritis (RA) and overall mortality. The study was conducted on participants aged 20 years or older living in the United States. We assessed RA status by using the arthritis question in the NHANES survey for the years 1999 to 2010 with mortality follow-up. We determined depression by Patient Health Questionnaire (PHQ-9). Prospective analysis was performed using complex samples Cox regression with adjustment for known confounders to determine the relationship of RA and mortality, and how depression has an overall relationship in females. The mean follow-up was 9.1 years. For all-cause mortality, the overall unadjusted hazard ratio (HR) of rheumatoid arthritis to no rheumatoid arthritis was 1.94 (95% confidence interval [CI], 1.25-4.01 p < 0.001). Adjusted HR was elevated, 2.13 (CI 0.98-4.62, p > 0.05), among patients with elevated C-reactive protein with RA but closer to 1.0 (1.90 CI 1.21-1.99, p > 0.05) among patients without depression, after controlling for medical and demographic risk factors. Similar patterns did not apply for males. RA has poorer outcomes especially when they have depression. These patterns exist among females but do affect males in the same way. Screening for depression should be a part of how rheumatologists treat patients. Disclosure S. Banerjee: None.