Suicidal thoughts related to pain in 1 in 10 patients with rheumatic or musculoskeletal disease

The results of a survey presented today at the Annual European Congress of Rheumatology (EULAR 2019) highlight the significant impact of rheumatic and musculoskeletal diseases (RMDs) on mental health and a worrying lack of psychological care.

"Not enough is being done to identify mental health issues and provide the support needed to RMD patients," said Professor Thomas Dörner, Chairperson of the Scientific Programme Committee, EULAR. "This survey highlights the huge importance of pain on the psychological well-being of RMD patients and the critical need to improve the support on offer. These results should act as a wake-up call to services across Europe."

A survey of over 900 RMD patients revealed that pain had caused one in ten to have suicidal thoughts within the previous four weeks. Pain had also caused 58% to feel that everything was unmanageable for them.

Another important finding was a reciprocal relationship between sleep and pain where 69% identified the quality of their sleep as having a negative influence on their pain. In return, two thirds of patients rarely or never feel fully rested when they wake up in the morning, with 36% taking painkillers to improve their sleep.

"Our study indicates that pain and poor quality of sleep have a huge impact on a patient's daily life, especially on their mental health," said Lene Mandrup Thomsen, the Danish Rheumatism Association, Denmark. "We are using the results of this study in our political work to help campaign for better treatment and support for patients with chronic pain in our healthcare system."

Of the participants, 83% have pain daily or several times a week and 46% have received strong painkillers over the last year. Despite a strong focus from Danish authorities on reducing their prescription, less than a quarter of respondents had been offered an alternative to strong painkillers.

The survey was created by the Danish Rheumatism Association and was completed by over 900 members of a user panel consisting of people who suffer from at least one RMD.

Results of another survey, also presented today at EULAR 2019, support these findings by revealing a worrying lack of psychological care for patients with rheumatoid arthritis and adult juvenile idiopathic arthritis (AJIA) in the UK.

In this survey, a quarter of the 1,620 people with rheumatoid arthritis or AJIA were experiencing clinical levels of anxiety or depression. Over half of these had never received a formal diagnosis. However, most concerningly, half of the respondents with rheumatoid arthritis and a third of those with AJIA who had either clinical levels or a formal diagnosis of anxiety or depression had never received any psychological support.

"Our results highlight that, despite guidelines, many patients in the UK are not receiving the psychological support they need," said Dr. Hayley McBain, Health Psychologist, City, University of London, United Kingdom. "It is imperative for rheumatology services to routinely measure anxiety and depression in order to intervene before the individual is in crisis."

The survey was conducted by the National Rheumatoid Arthritis Society (NRAS) in the UK and was designed by patients and researchers. Participants were recruited via social media platforms, membership and non-membership lists and in newsletters and forums. Recruitment was focused on those diagnosed with rheumatoid arthritis or AJIA aged 18 years and over.