A Study to Assess the Relationship Between Depression and Osteoarthritis According to the Severity of Pain and Loss of Function

Abstract

Background & Objective: As there is increase in the obesity and elderly population worldwide,
Osteoarthritis(OA) diseaseisunfortunatelyontherise.Whenthedurationofdiseaseincreases,thereis achancethat
the psychological morbidity evolves into depression .The objective of this study is to assess a relationship
betweendepression and osteoarthritis according to the severity of pain and loss of function.
Methods: This cross-sectional study was conducted at Orthopedic and Rheumatology department of
Combined Military Hospital, Lahore from October 2022 to March 2023. All the patients reporting to the
outpatient department of either gender aged more than 45 years with a diagnosis of OA based on X-ray
findings and a consultant review were included in our study. Severity of OAwas studied using the WOMAC
(Western Ontario and McMaster Universities) Osteoarthritis Index. Depression was measured using the
Personal Health Questionnaire (PHQ-9) scale in these patients simultaneously. (12) It was translated in Urdu
for the ease of our participants.
Results: Out ofthe 196 participants of ourstudy, 71 (36.2%)weremaleswhile 125 (63.8%)were females.Mean
age of the participants of our study was 55.49 Years + 8.98. Mean WOMAC index score was 61.02 + 19.11. 3
(1.5%) patients of OA had mild disease in our study and no depression was found in them. In the moderate
disease group, 34 (17.3%) had no symptoms of depression, 62 (31.6%) had minimal depression, none had
mild,moderate orsevere depressionwhile only 1 (0.5%) hadmoderately severe depression.Out of 96 (48.9%) of
the OApatients with severe disease as per the WOMAC index, 3 (1.5%) had minimal depression, 47 (23.9%)
had mild depression, 15 (7.6%) had moderate depression, 27 (13.8%) had moderately severe depression and
4 (2.0%) had severe depression.
Conclusion: OAis a debilitating disease. Quality oflife of patientsisseverely affected asthe duration increases
due to pain, stiffness and loss of function of joints. Long term disease leads to depression of variable degrees. .
Thus early diagnosis and timely intervention in such patients with an individualized management plan can
improve the outcome and quality of life of patients.