Effect of type of disease-modifying antirheumatic drugs on depression and anxiety of patients with rheumatoid arthritis in Saudi Arabia: a cross-sectional study

Background

Rheumatoid arthritis (RA) can cause depression and anxiety. This study evaluated the factors associated with depression and anxiety in patients with RA and examined the effect of conventional and biologic disease-modifying antirheumatic drugs (DMARDs).

Methods

This cross-sectional study was conducted in a regional hospital in Riyadh between March and November 2022 and included 213 patients with RA. Depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS) and data about patients' DMARDs use was obtained from the hospital's medical records.

Results

Based on the HADS scores, 35 (16.4%) and 49 (23%) patients with RA had depression and anxiety, respectively. There was a significant association between the level of depression and anxiety and the use of leflunomide and tocilizumab among patients with RA (p = 0.006 and p = 0.009, respectively). Patients with RA who took leflunomide had significantly higher scores for anxiety (β = 0.158, value of p = 0.037) when compared to patients who did not take leflunomide. Patients with RA who took etanercept showed a significantly lower depression score even after adjusting for confounders, including sociodemographic, clinical, and lifestyle factors (β = -0.189, p = 0.043).

Conclusion

The present study highlighted the prevalence of psychiatric disorders among patients with RA and the level of depression and anxiety may differ between patients with RA depending on the type of DMARDs used. We recommend patients with RA be screened regularly for depression and anxiety to avoid further extra-articular systemic complications associated with RA.

Awareness Level of Cancer Risk Factors and Warning Signs and Cancer Campaign Attendance behavior among Saudi Adults in a Tertiary Hospital in Riyadh

Objective:

To estimate the awareness level of Saudi adults about the risk factors and warning signs of cancer and observe the association of different determinants with cancer Knowledge in Riyadh city.

Methods:

A cross-sectional study carried out on 390 Saudis in the outpatient clinics of King Khalid University Hospital (KKUH), Riyadh. Data was collected using a validated Arabic questionnaire. Data was analyzed using SPSS software.

Results:

The overall awareness of the participants was limited, as the mean score of the overall cancer knowledge was 49.2%. Most of the correctly answered questions were on general cancer knowledge and not about risk factors or warnings signs. The only risk factors identified by most participants were smoking, alcohol, air pollution and genetic factors. Important risk factors such as physical inactivity, low dietary fibers and obesity were not well known. Despite Hepatitis B virus infection (HBV) being endemic in the kingdom, only 30% identified it as a risk factor. Apart from “A Thickening or a lump in breast or other organs”, < 50% of participants recognized alarming warning signs such as unexplained weight loss, unusual bleeding, and change in bowel habits. Females were more inclined to attend cancer awareness campaigns. Though people who reported attendance of cancer awareness campaigns surprisingly did not achieve a significantly higher overall knowledge score.

Conclusion:

The public lacks knowledge of well-established cancer risk factors and warning signs, despite recent advances in the medical field. Results suggest that current strategies to educate the public need to be revised.