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Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms


Zheng, S and Tu, L and Cicuttini, F and Zhu, Z and Han, W and Antony, B and Wluka, AE and Winzenberg, T and Aitken, D and Blizzard, L and Jones, G and Ding, C, Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms, BMC Musculoskeletal Disorders, 22, (1) Article 40. ISSN 1471-2474 (2021) [Refereed Article]

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Copyright Statement

The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) License, ( which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.

DOI: doi:10.1186/s12891-020-03875-1


Background: To describe demographic and clinical factors associated with the presence and incidence of depression and explore the temporal relationship between depression and joint symptoms in patients with symptomatic knee osteoarthritis (OA).

Methods: Three hundred ninety-seven participants were selected from a randomized controlled trial in people with symptomatic knee OA and vitamin D deficiency (age 63.3 7.1 year, 48.6% female). Depression severity and knee joint symptoms were assessed using the patient health questionnaire (PHQ-9) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively, at baseline and 24 months.

Results: The presence and incidence of depression was 25.4 and 11.2%, respectively. At baseline, having younger age, a higher body mass index (BMI), greater scores of WOMAC pain (PR: 1.05, 95%CI:1.03, 1.07), dysfunction (PR: 1.02, 95%CI:1.01, 1.02) and stiffness (PR: 1.05, 95%CI: 1.02, 1.09), lower education level, having more than one comorbidity and having two or more painful body sites were significantly associated with a higher presence of depression. Over 24 months, being female, having a higher WOMAC pain (RR: 1.05, 95%CI: 1.02, 1.09) and dysfunction score (RR: 1.02, 95%CI: 1.01, 1.03) at baseline and having two or more painful sites were significantly associated with a higher incidence of depression. In contrast, baseline depression was not associated with changes in knee joint symptoms over 24 months.

Conclusion: Knee OA risk factors and joint symptoms, along with co-existing multi-site pain are associated with the presence and development of depression. This suggests that managing common OA risk factors and joint symptoms may be important for prevention and treatment depression in patients with knee OA.

Item Details

Item Type:Refereed Article
Keywords:depression, joint symptoms, knee osteoarthritis, risk factors
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Rheumatology and arthritis
Objective Division:Health
Objective Group:Clinical health
Objective Field:Prevention of human diseases and conditions
UTAS Author:Zheng, S (Miss Shuang Zheng)
UTAS Author:Zhu, Z (Mr Zhaohua Zhu)
UTAS Author:Han, W (Dr Weiyu Han)
UTAS Author:Antony, B (Dr Benny Eathakkattu Antony)
UTAS Author:Winzenberg, T (Professor Tania Winzenberg)
UTAS Author:Aitken, D (Associate Professor Dawn Aitken)
UTAS Author:Blizzard, L (Professor Leigh Blizzard)
UTAS Author:Jones, G (Professor Graeme Jones)
UTAS Author:Ding, C (Professor Chang-Hai Ding)
ID Code:147241
Year Published:2021
Web of Science® Times Cited:17
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-10-20
Last Modified:2022-12-06
Downloads:9 View Download Statistics

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