The Rheumatologist reports on the findings of a study published in Arthritis Care & Research which showed people with or at risk for symptomatic knee osteoarthritis (OA) may be assigned to four depression subtypes with distinct clusters of depressive symptoms over time. The study also indicated the need for depression screening tools.

The Rheumatologist spoke to Adena Batterman, MSW, LCSW, senior manager of inflammatory arthritis support and education programs at HSS, who explained HSS screens all rheumatology patients at intake, which when appropriate, triggers referrals to mental health services. Batterman said, "As part of a comprehensive psychosocial assessment, social workers screen patients for all issues that may impact your ability to cope with a rheumatic disease." She added, “There is a surprisingly low incidence of rheumatologists asking about these issues in medical encounters. It’s important to make this screening part of a normal exam routine because of the profound impact of depression on RA disease outcomes. It’s all a part of treating the person as a whole.”

Karmela Kim Chan, MD, rheumatologist at HSS, also provided commentary to The Rheumatologist about the barriers to effective depression screening and referral in rheumatology, which include short appointments, and a lack of clear clinical directives about mental health. “There are no treatment guidelines on mental health along the lines of treat to target, for example. But it is very important,” explained Dr. Chan. Psychological symptoms “may alter a patient’s subjective scores for pain or fatigue, so it definitely plays a role in clinical decision making,” she cited. “I won’t shy away from bringing up mental health issues with my patients. Instinctively, we know that when we’re treating someone with a rheumatic disease, there may be a mental health component. It’s important not to forget about this,” she concluded.

Read the article at the-rheumatologist.org.