Anxiety and depression in patients with osteoarthritis: impact and management challenges

Anirudh Sharma,1 Prtha Kudesia,2 Qian Shi,2 Rajiv Gandhi2 1Division of Genetics and Development, Krembil Research Institute, 2Division of Orthopaedic Surgery, Toronto Western Hospital, Toronto, ON, Canada Background: Anxiety and depression are common psychological comorbidities that impact the quality of life (QoL) of patients. In this systematic review, we 1) determined the impact of anxiety and depression on outcomes in patients with osteoarthritis (OA) and 2) summarized unique challenges these comorbidities present to current OA management.Patients and methods: A systematic literature search was performed using the OVID Medline and EMBASE databases until April 2016. Full-text research articles published in English from the year 2000 onward with a sample size of >100 were included in this review. Eligible research articles were reviewed and the following data were extracted: study author(s), year of publication, study design, and key findings. Results: A total of 38 studies were included in the present review. The present study found that both anxiety and/or depression were highly prevalent among patients with OA. Patients with OA diagnosed with these comorbidities experienced more pain, had frequent hospital visits, took more medication, and reported less optimal outcomes. Management strategies in the form of self-care, telephone support, audio/video education programs, and new pharmacotherapies were reported with favorable results. Conclusion: Anxiety and depression adversely impact the QoL of patients with OA. Physicians/caregivers are highly recommended to consider these comorbidities in patients with OA. Ultimately, a holistic individualized management approach is necessary to improve patient outcomes. Keywords: osteoarthritis, anxiety, depression, impact, managemen