Rheumatoid arthritis (RA) the most common form of chronic inflammatory arthritis is a debilitating disease characterized by inflammation of joint tissues, persistent pain, functional disability, stiffness and fatigue.

Betsy Sleath, PhD, a professor at the UNC School of Pharmacy, said that although depression in primary care settings has been well examined, no previous studies have looked at whether rheumatologists and RA patients discuss depression during medical visits.

In a new study lead by Sleath and published in this month's issue of Arthritis Care & Research, researchers found that almost 11 percent of RA patients had moderately severe to severe symptoms of depression. Those who were rated as being morerestricted in their normal activities were significantly more likely to have these symptoms.

The study also found that only one in five of the patients who showed symptoms of depression discussed it with their rheumatologists. Those who did were always the ones to bring up the topic, not the physician. When depression was brought up, it was often not discussed at any length.

Sleath said when patients visit their specialist, their arthritis is understandably their main focus but rheumatologists should consider addressing both RA and depression when they see their patients.

Chronic diseases can greatly affect a patient's psychosocial well-being, and depression can also affect a patient's adherence to treatment regimens," Sleath said. "Since many arthritis patients see their rheumatologist more often then their primarycare physician, we recommend that rheumatologists take steps to screen patients for signs of depression."

Sleath said if physicians are uncomfortable discussing depression with their patients, they should consider having their office staff administer a brief depression screening before the patients' visits in order to identify problems early on.