Psychological and social needs of people with rheumatoid arthritis

Inflammatory arthritis, such as rheumatoid arthritis, is common and affects between 0.5% and 1% of the UK population (Abhisheki et al, 2017). It is a life-changing diagnosis and lifelong illness requiring specialist care and complex immunosuppressive therapies. The symptoms of joint pain, joint swelling and fatigue are unpredictable but when active (often known as a flare) impact on a person's general wellbeing. This commentary will focus on the potential impact on mood and work.

Rheumatoid arthritis (RA) is associated with an increased prevalence of depression and anxiety (Matcham et al, 2013). The level of depression is similar to that experienced by people with diabetes, Parkinson's disease and cancer (Matcham et al, 2013). Psychological distress in inflammatory arthritis can relate to many factors including coping with fluctuating daily symptoms, restriction in social activities, the emotional impact of living with a long-term condition and managing complex medication regimens (Dures et al, 2014). It is important to identify if depression is occurring as, left untreated, it can lead to poorer patient outcomes including increased pain and fatigue, reduced physical ability, withdrawal from normal activities and limited response to drug treatments (Hider et al, 2009; Matcham et al, 2013).