Rheumatology patients must undergo screening for anxiety, depression, FM: study

A significant proportion of rheumatology patients have been diagnosed with anxiety, depression, or fibromyalgia (FM), reveals a study, noting the importance of including screening for clinical decisions at all routine encounters.

A total of 1,337 patients were given a Multidimensional Health Assessment Questionnaire (MDHAQ) at each encounter to provide comprehensive medical history information.

The investigators computed the frequencies of positive MDHAQ anxiety, depression, and FM screening in patients with 15 rheumatic diagnoses in five categories: inflammatory, connective tissue, bone mineral disorders, noninflammatory, and primary FM. They compared median pain on a 0‒10 visual numerical scale and Routine Assessment of Patient Index Data 3 (RAPID3) scores from 0 to 30 in patients with positive vs negative screens.

Of the patients (excluding primary FM), 30 percent had positive screens for anxiety, 24 percent for depression, 25 percent for nonprimary FM, and 44 percent for any of these three multimorbidity screens.

Positive screens in various rheumatic diagnosis categories ranged from 17 percent to 39 percent for anxiety, 9 percent to 33 percent for depression, 7 percent to 31 percent for nonprimary FM, and 30 percent to 52 percent for any multimorbidity screen.

Patients with any of three positive vs all negative screens had median pain of 7.0/10 vs 4.0/10 and median RAPID3 of 17.0/30 vs 8.2/30.

“Positive anxiety, depression, and/or FM screens in 44 percent of routine care patients who have significantly higher pain scores agree with extensive research findings, suggesting inclusion of pragmatic screening for clinical decisions at all routine encounters,” the investigators said.