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Open Access 01-12-2021 | Knee Osteoarthritis | Research article

Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms

Authors: Shuang Zheng, Liudan Tu, Flavia Cicuttini, Zhaohua Zhu, Weiyu Han, Benny Antony, Anita E. Wluka, Tania Winzenberg, Dawn Aitken, Leigh Blizzard, Graeme Jones, Changhai Ding

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

To describe demographic and clinical factors associated with the presence and incidence of depression and explore the temporal relationship between depression and joint symptoms in patients with symptomatic knee osteoarthritis (OA).

Methods

Three hundred ninety-seven participants were selected from a randomized controlled trial in people with symptomatic knee OA and vitamin D deficiency (age 63.3 ± 7.1 year, 48.6% female). Depression severity and knee joint symptoms were assessed using the patient health questionnaire (PHQ-9) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively, at baseline and 24 months.

Results

The presence and incidence of depression was 25.4 and 11.2%, respectively. At baseline, having younger age, a higher body mass index (BMI), greater scores of WOMAC pain (PR: 1.05, 95%CI:1.03, 1.07), dysfunction (PR: 1.02, 95%CI:1.01, 1.02) and stiffness (PR: 1.05, 95%CI: 1.02, 1.09), lower education level, having more than one comorbidity and having two or more painful body sites were significantly associated with a higher presence of depression. Over 24 months, being female, having a higher WOMAC pain (RR: 1.05, 95%CI: 1.02, 1.09) and dysfunction score (RR: 1.02, 95%CI: 1.01, 1.03) at baseline and having two or more painful sites were significantly associated with a higher incidence of depression. In contrast, baseline depression was not associated with changes in knee joint symptoms over 24 months.

Conclusion

Knee OA risk factors and joint symptoms, along with co-existing multi-site pain are associated with the presence and development of depression. This suggests that managing common OA risk factors and joint symptoms may be important for prevention and treatment depression in patients with knee OA.

Trial registration

ClinicalTrials.gov identifier: NCT01176344.

Anzctr.org.au identifier: ACTRN12610000495022.

Available only for authorised users

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Title: Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms
Authors: Shuang Zheng
Liudan Tu
Flavia Cicuttini
Zhaohua Zhu
Weiyu Han
Benny Antony
Anita E. Wluka
Tania Winzenberg
Dawn Aitken
Leigh Blizzard
Graeme Jones
Changhai Ding
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Knee Osteoarthritis
Osteoarthrosis
Affective Disorder
Osteoarthrosis
Affective Disorder
Knee Osteoarthritis
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-020-03875-1

At a glance: The STEP trials

Springer Medicine

Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms

Abstract

Background

Methods

Results

Conclusion

Trial registration

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Trial registration

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