Depression in early rheumatoid arthritis (ERA) is common and initial high disease activity is associated with the probability of depression and its persistence, a recent study found. This risk seems particularly modified in women with active disease and represents an area for targeted focus and screening. Depression was ascertained by self-report among patients enrolled in a best practices research initiative. The association between baseline disease activity, measured by the Clinical Disease Activity Index (CDAI), and persistent depression was evaluated with multivariate regression models, and effect modification by sex was tested. The sample of 469 ERA subjects was predominantly female (73%). Researchers found:

• At baseline, the prevalence of depression was 26%, and 23% reported persistent depression.
• After adjusting for potential confounders, higher baseline CDAI was associated with both baseline and persistent depression.
• Female sex was an effect modifier of this relationship.
• Maintaining a moderate or high CDAI score over 2 years also increased the risk of future depression.