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Predictors of depression trajectories during the COVID-19 pandemic in adults with rheumatoid arthritis: results from the Canadian Early Arthritis Cohort

Title: Predictors of depression trajectories during the COVID-19 pandemic in adults with rheumatoid arthritis: results from the Canadian Early Arthritis Cohort
Authors: Bartlett, Susan J; Schieir, Orit; Valois, Marie-France; Boire, Gilles; Tin, Diane; Pope, Janet E; Hitchon, Carol A; Hazlewood, Glen; Thorne, Carter; Bessette, Louis; Allard-Chamard, Hugues; Kuriya, Bindee; Bykerk, Vivian P; Akhavan, P; Barber, C; Barra, L; Bessette, L; Boire, G; Bykerk, V; Colmegna, I; Fallavollita, S; Haaland, D; Haraoui, P; Hazlewood, G; Hitchon, C; Jamal, S; Joshi, R; Keystone, E; Kuriya, B; Panopalis, P; Pope, J; Thorne, C; Villeneuve, E; Zummer, M
Contributors: Amgen and Pfizer Canada since 2007; Hoffman La Roche
Source: Rheumatology Advances in Practice ; volume 9, issue 4 ; ISSN 2514-1775
Publisher Information: Oxford University Press (OUP)
Publication Year: 2025
Description: Objectives Growing evidence points to mental health impacts of coronavirus disease 2019 (COVID-19). We explored trajectories of depressive symptoms in the year pre- and 2 years post-pandemic onset in adults with RA. Methods Data are from the Canadian Early Arthritis Cohort (CATCH), a prospective, multicentre, early RA cohort of Canadian adults treated by rheumatologists. Pre-pandemic, participants completed patient-reported outcome measures and rheumatology exams in person. After March 2020, patient-reported outcomes were collected at in-person and virtual visits. We used group-based trajectory modelling to explore longitudinal patterns of depressive symptoms prior to and throughout the COVID-19 pandemic and multinomial regression to identify factors associated with depression trajectory group. Results A total of 989 participants had a mean age of 60 years (s.d. 14), RA for 6 years (s.d. 4) and were mostly white (84%) and female (73%) with some college education (60%). Most (77%) were in Clinical Disease Activity Index remission/low disease activity prior to the pandemic. We identified four trajectories: resilient (no symptoms throughout: 60%), worsening (none–mild: 22%), improving (mild–minimal: 8%) and persistent (moderate–severe throughout: 9%). Age, sex, race, education, pain, physical and social functioning, fibromyalgia and history of anxiety/depression were associated with different trajectories. Conclusion Although 60% had a consistent affect during the first 2 years of the pandemic, mood worsened in greater than one in five, suggesting a cumulative impact over time. Biological, psychological and social factors and worse pre-pandemic symptoms and function were associated with a greater risk of depression during the pandemic. Identifying at-risk groups impacted by major stressors like the pandemic may offer new opportunities to personalize treatment, allocate resources, reduce disease flares and improve outcomes.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/rap/rkaf120
DOI: 10.1093/rap/rkaf120/64833421/rkaf120.pdf
Availability: https://doi.org/10.1093/rap/rkaf120; https://academic.oup.com/rheumap/advance-article-pdf/doi/10.1093/rap/rkaf120/64833421/rkaf120.pdf; https://academic.oup.com/rheumap/article-pdf/9/4/rkaf120/64833421/rkaf120.pdf
Rights: https://creativecommons.org/licenses/by-nc/4.0/
Accession Number: edsbas.FE783A1C
Database: BASE