Depression in rheumatic disease 4.25/5 (8)

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Definition

Depression is a disease characterized by persistently low mood, low self-esteem and lost interest in activities that normally bring pleasure. Chronic rheumatic disease (rheumatism) with pain, reduced sleep, fatigue and loss of physical function, as well as negative events, lack of sleep and stress factors increase the risk of developing depression (Shand SP, 2022).

Occurrence

Depression in rheumatic disease
Depression is quite common in rheumatic diseases. Pxhere. CC0

As many as 7% experience depression during a 12-month period. The incidence (prevalence) in the 18-29 age group is three times higher than in the 60 and over age group. Women are attacked 1,5-3 times more often than men (Shand SP, 2022).

Symptoms

Typical symptoms of depression are feelings of loneliness, helplessness, hopelessness, worthlessness, obsessive thoughts, worry about the future, brooding over the past, guilt, exhaustion, reduced concentration and memory. Joint and muscle pain, varying stool patterns, irritability and restlessness can also be part of the disease picture.

Examinations

Medical history ask for typical symptoms (see above), predisposing and possible triggering causes in the environment (heredity, events, illness, new drugs).

Clinical one can observe difficulties in making decisions, thoughts of suicide ("life is not worth living"), loss of pleasure in activities that one previously valued, social isolation, lack of initiative, changed sleep patterns (too little or too much sleep ), changed appetite (reduced or increased, especially for carbohydrates). Tests for depression: MATRS. Investigations to rule out signs of other concurrent diseases such as neurological, rheumatological or metabolic (endocrinological) disease may be relevant.

Blood tests expected to be unaffected by depression. To rule out other causes of illness, cell counts (hemoglobin, white blood cells, platelets), salts including calcium, liver-kidney and metabolism tests, vitamin B12 and cortisol may be relevant.

Urine can be examined if kidney disease is suspected.

Imaging is not always necessary. If neurological disease in the brain is suspected, CT and/or MRI of the head is appropriate.

Similar conditions, differential diagnoses

There are many illnesses that can resemble depression (eg low metabolism (hypothyreosis) or hyperpara-thyroidism). Closer medical assessment of the symptoms and blood tests may be important for clarification.

Treatment

Prevention with regular and sufficient sleep, avoid a lot of alcohol, do not use drugs. Physical activity and exercise and social activity together with others are recommended. It is also important to tell the doctor (primarily the GP) about symptoms. Effective treatment can be found, among other things, in the form of talk therapy and medication.

Literature


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