Factors Associated with Depression and Suicidal Ideation Among Individuals with Arthritis or Rheumatism: Findings from a Representative Community Survey

Objective: To investigate factors associated with depression and suicidal ideation among individuals with arthritis or rheumatism.

Methods: The nationally representative Canadian Community Health Survey 2000-2001 included 130,880 respondents (response rate 84.7%). Respondents were diagnosed as depressed using a subset of items from the Composite International Diagnostic Interview. There were 23,405 respondents age > or =20 years who reported that they had been diagnosed with arthritis or rheumatism by a health professional. Logistic regression analyses were conducted to investigate depression and suicidal ideation.

Results: One in 10 Canadians with arthritis had clinically relevant levels of major depression. The age- and sex-adjusted odds ratios (ORs) of major depression (OR 2.24, 95% confidence interval [95% CI] 2.11-2.38) and suicidal ideation (OR 2.01, 95% CI 1.75-2.31) among those with arthritis were approximately twice that of those without arthritis. The adjusted ORs of major depression among those with arthritis were significantly higher among women, the unmarried, younger, and poorer individuals. Individuals in pain, with limitations in activities of daily living, with limitations in instrumental activities of daily living, and with greater numbers of chronic conditions had higher odds of major depression. Less than half of those with major depression had consulted a mental health professional. One in 5 individuals with arthritis and major depression had been suicidal in the past year.

Conclusion: The majority of individuals with arthritis and major depression were not receiving adequate treatment for major depression. Clients should be screened for major depression and suicidal ideation, particularly if they fall into the identified vulnerable groups.