An Exploration of the Incidence Rate of Anxiety and Depression Following a Diagnosis of Rheumatoid Arthritis Using the THIN Dataset
Author(s)
Ben Hammond, MSci1, Samuel Cusworth, MSc1, Illin Gani, MSc1, Bianca Ungureanu, -1, Katherine Blundell-Doyle, -1, Neil Cockburn, MBChB1, Caroline Eteve-Pitsaer, MSc2, Christian Billinghurst, MPH3, Karim Raza, PhD1, Joht Singh Chandan, PhD1.
1University of Birmingham, Birmingham, United Kingdom, 2Cegedim Health data, Boulogne-Billancourt, France, 3Dexter, London, United Kingdom.
1University of Birmingham, Birmingham, United Kingdom, 2Cegedim Health data, Boulogne-Billancourt, France, 3Dexter, London, United Kingdom.
OBJECTIVES: Rheumatoid arthritis (RA) is a chronic inflammatory disease that can lead to joint damage, significant disability and widespread underlying inflammation and linked co-morbidities. Existing literature has highlighted a link between RA and mental health conditions and both joint pain and disability, as well as underlying inflammation, have been suggested as possible causes.
METHODS: To investigate trends in mental health diagnosis following RA, we reported the yearly incidence rate of new cases of depression and anxiety following a diagnosis of RA between January 1st 2006 and December 31st 2021. We calculated the incidence rate utilising The Health Improvement Network (THIN) database, a large primary care dataset of UK general practices, extracted using Dexter. All results were directly standardised with the 2021 UK mid-year population estimates produced by ONS.
RESULTS: Across the study period, the incidence rate of depression following an RA diagnosis decreased from 1985 [CI: 1638-2365] per 100,000 person years in 2006 to 1549 [1277-1848] in 2019, however, this was not statistically significant. The incidence rate of anxiety conversely rose from 1049 [838-1285] per 100’000 person years in 2006 to 1156 [915-1423] in 2019 but this was also not statistically significant. In both outcomes, the incidence rate fell during the Covid-19 period to 846 [659-1058] per 100,000 person years for depression and 741 [563-945] per 100,000 person years for anxiety.
CONCLUSIONS: In line with existing literature, depression presents as a substantial co-morbid disease following a diagnosis of RA. Additionally, the results present a likely underestimation of the true burden as not all patients will receive a formal diagnosis. This all highlights the need for increased mental health support concurrent to secondary care referral and treatment of RA by specialist led rheumatology care.
METHODS: To investigate trends in mental health diagnosis following RA, we reported the yearly incidence rate of new cases of depression and anxiety following a diagnosis of RA between January 1st 2006 and December 31st 2021. We calculated the incidence rate utilising The Health Improvement Network (THIN) database, a large primary care dataset of UK general practices, extracted using Dexter. All results were directly standardised with the 2021 UK mid-year population estimates produced by ONS.
RESULTS: Across the study period, the incidence rate of depression following an RA diagnosis decreased from 1985 [CI: 1638-2365] per 100,000 person years in 2006 to 1549 [1277-1848] in 2019, however, this was not statistically significant. The incidence rate of anxiety conversely rose from 1049 [838-1285] per 100’000 person years in 2006 to 1156 [915-1423] in 2019 but this was also not statistically significant. In both outcomes, the incidence rate fell during the Covid-19 period to 846 [659-1058] per 100,000 person years for depression and 741 [563-945] per 100,000 person years for anxiety.
CONCLUSIONS: In line with existing literature, depression presents as a substantial co-morbid disease following a diagnosis of RA. Additionally, the results present a likely underestimation of the true burden as not all patients will receive a formal diagnosis. This all highlights the need for increased mental health support concurrent to secondary care referral and treatment of RA by specialist led rheumatology care.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH13
Topic
Epidemiology & Public Health
Topic Subcategory
Disease Classification & Coding, Public Health
Disease
Mental Health (including addition), Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)