DEPRESSION AND THE LONG-TERM RISK OF PAIN, FATIGUE, AND DISABILITY INPATIENTS WITH RHEUMATOID-ARTHRITIS

Objective. To determine whether a previous episode of major depression leaves a ''scar'' that places previously depressed patients with rheu matoid arthritis (RA) at risk for experiencing high levels of pain, fa tigue, and disability, Methods. A cohort of 203 patients with RA was r andomly selected from a national panel and interviewed by phone about pain, fatigue, depressive symptoms, disability, and history of major d epression. Results, Excluding patients who met the criteria for curren t major depression, patients with both a history of depression and man y depressive symptoms at the time of the interview (dysphoria) reporte d more pain than those without current dysphoria, irrespective of whet her they had a history of depression. Dysphoria alone was not reliably related to pain reports. Conclusion. An episode of major depression, even if it occurs prior to the onset of RA, leaves patients at risk fo r higher levels of pain when depressive symptoms persist, even years a fter the depressive episode.