Prevalence and Factors Associated with Anxiety and Depression in Rheumatoid Arthritis Patients in Addis Ababa, Ethiopia: A Multi-Center Cross-Sectional Study

Background and aim: Rheumatoid arthritis (RA) is a chronic inflammatory disorder that impacts both physical and mental health. Depression and anxiety are common comorbidities among RA patients, which may impact disease outcomes and quality of life. However, there is limited data in Ethiopia. Therefore, the aim of this study is to determine the prevalence of anxiety and depression among RA patients, and to explore the factors contributing to these mental health disorders in Addis Ababa, Ethiopia,. Methods : A multicenter cross-sectional study was conducted among 291 RA patients who had follow up at rheumatology clinics (Tikur Anbessa specialized hospital, Lancet General Hospital and Rheum - Rheumatology and Internal medicine specialty center) in Addis Ababa, Ethiopia. Chart review and interviews were used to collect data. Participants in the study were recruited using a simple sampling method. Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7) were used to assess depression and anxiety. SPSS 27.1 was used for data analysis. Descriptive analysis used to summarize data using mean with standard deviation, median with interquartile range, and mode. Binary logistic regression analysis was used to identify factors associated with depression and anxiety. Results : The mean age of the participants was 51.18 years (±13.05), with 86.3% female. The prevalence of depression and anxiety among the RA patients was 39.9% and 32.4%, respectively. In multivariable logistic regression female sex (AOR = 5.13; 95% CI: 1.87–14.0; p = 0.001), poor medication adherence (AOR = 6.59; 95% CI: 2.35–18.4; p < 0.001), moderate to severe disability (AOR = 3.96; 95% CI: 2.15–7.31; p < 0.001), severe to very severe disability (AOR = 6.66; 95% CI: 1.82–24.3; p = 0.004), and high disease activity (AOR = 3.26; 95% CI: 1.60–6.63; p = 0.001) were all independently associated with increased odds of depression and anxiety. These factors were also independently associated with anxiety among RA patients, although with a lower odds ratio than that found for depression. Conclusion and recommendation : This study showed that depression and anxiety are highly prevalent among RA patients in Addis Ababa and disease-related factors such as disease activity, poor medication adherence and disability are major contributors to mental health burden. Mental health screening should be an integral part of RA that underscores the need for comprehensive management to improve overall patient care and outcomes.