A comprehensive cross-sectional study has found that patients with systemic autoimmune diseases may experience significantly higher rates of depression and anxiety compared with those with rheumatoid arthritis, with notable impacts on physical activity and early retirement rates.

The study, published in Frontiers in Medicine and conducted at Hannover Medical School between January 2019 and March 2021, examined 445 patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and primary Sjögren's syndrome. The research revealed that 28.5% of the patients exhibited depression symptoms, with particularly high rates among those with SLE (28.8%) and Sjögren's syndrome (36.3%) compared with the patients with RA (22%).

"Depression and anxiety are highly prevalent in RA, SLE, and [Sjögren's syndrome], particularly in SLE and [Sjögren's syndrome]," the study authors reported. "The study highlights the need for early psychological evaluation and integrated care involving rheumatologists and mental health professionals to address these issues and improve physical and mental well-being," they added.

The investigation found that anxiety affected 31.2% of the total cohort, with patients who had SLE and Sjögren's syndrome showing notably higher rates (35.6% and 36.3%, respectively) compared with patients who had RA (23.2%). Physical inactivity was more prevalent among the patients with SLE (44.5%) and Sjögren's syndrome (44.4%) compared with those with RA (39.0%), with depression significantly correlating with reduced physical activity levels.

One particular finding was the high rate of early retirement, particularly among patients with systemic conditions. The study found that 85% of SLE retirees and 66% of Sjögren's syndrome retirees had retired early compared with 49% of RA retirees. All patients with Sjögren's syndrome cited their underlying disease as the cause for early retirement, while 31.7% of those with SLE and 10.8% of those with RA attributed their early retirement to other causes.

Disease activity showed significant correlation with psychological status across conditions. Among the patients with RA, those with depression demonstrated approximately 25% higher disease activity scores compared with those without depression. In the patients with Sjögren's syndrome, subjective symptoms such as pain and fatigue showed strong correlations with both anxiety and depression.

The study also revealed that patients with depression had a shorter average disease duration (103 vs 140 months) compared with those without depression, suggesting that psychological support may be particularly crucial in the early years following diagnosis.

Fatigue emerged as a significant concern, affecting 64% of all patients, with patients who had SLE showing the highest prevalence at 73.3%. The research indicated that fatigue correlated strongly with both mental health symptoms and reduced physical activity levels.

The study authors emphasized the importance of comprehensive care approaches, stating, "Ongoing monitoring, not only of disease-specific activity but also of mental health, is essential for ensuring optimal and holistic care of chronically ill patients."

The study explored the psychological burden of rheumatic diseases and acknowledged limitations, including the monocentric nature of the study and potential selection bias due to voluntary participation. The investigators recommended incorporating cognitive function tests in future research to enhance result comparability.

The authors declared having no competing interests.