Research explores link between mental health and rheumatoid arthritis

A nurse talking to an elderly patient in her own home.

A new study has gone further towards ensuring people living with both rheumatoid arthritis and mental health problems get the best treatment for them.

Rheumatoid arthritis affects the whole body, but we know that it can also have an impact on a person’s mental health. Around a third of the 400,000 people in the UK with rheumatoid arthritis also experience mental health issues. This compares to around 1 in 4 people in the general population.

The way rheumatoid arthritis is treated was revolutionised by the discovery of anti-TNF drugs – now widely used in medical practice. Better treatments have led to more people achieving remission. But, while there has been much research into how these drugs improve physical health and reduce joint damage, little is known about their impact on people’s quality of life.

Emerging evidence suggests that there are similarities between the biological processes that cause rheumatoid arthritis and those underlying depression. This presents the possibility that existing treatments could do more to improve the quality of life of people with arthritis – in terms of both their physical and mental health.

In a bid to improve the way arthritis and mental health problems are treated Dr Sam Norton, Dr Faith Matcham and colleagues at King's College London recently published a review of clinical trials in rheumatoid arthritis. The researchers looked at how often mental health was assessed in these trials, how drug treatment affected people’s mental health, and considered other factors influencing the development of mental health conditions. As part of this work, the team analysed the results from over 50 studies involving more than 23,000 people.

Their review, recently published in the scientific journal Arthritis and Rheumatology, found that treating a person’s arthritis may not always improve their mental health. Instead, the researchers concluded that a person’s mental health condition should be considered alongside arthritis and treated at the same time.

Dr Sam Norton, researcher on the study commented: "Treatments for rheumatoid arthritis are highly effective at controlling disease activity and halting joint damage. However, many people continue to experience issues with their mental health. This research shows it is important for trials to consider the impact of treatments on mental health, and more broadly the need for rheumatology services to identify and support those people who might need additional support with their mental health."

Dr Natalie Carter, Head of Research Liaison and Evaluation at Versus Arthritis said: “This research shows just how important it is that people get integrated and dedicated mental health care alongside treatment for their physical symptoms. We hope these findings will ultimately help health care professionals and people with arthritis to find better solutions."

We know arthritis can have a profound impact that reaches well beyond people’s joints. That’s why we want to keep funding studies to help people manage all aspects of their health, and unlock a better quality of life.

This independent research was part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London.