To examine the role of function and functional changes in the development of depressive symptoms among women with rheumatoid arthritis (RA).
Methods. Data from a longitudinal panel study of persons with RA were used. Functional changes were assessed from 1989 to 1991, and depressive symptoms during 1992.
Results. Loss of valued activities was a significant risk factor for developing depressive symptoms (i.e., score of 2 7 on the Short Form Geriatric Depression Scale), but overall functional decline was not.
Conclusion. The aspect of functional decline that leads to development of depressive symptoms is the loss of valued activities, not simply the functional impairment.
Depression is an important problem among persons with rheumatoid arthritis (RA). It appears to be more prevalent among persons with RA than in the general population (1-3). Moreover, studies of persons with RA have demonstrated cross-sectional relationships between depression or depressive symptoms and impaired functioning and poor clinical status (4-7). For example, we have found that, among a group of RA patients, those with depressive symptoms had poorer function, were more likely to have a major physical limitation, spent more days in bed, and reported more joints with pain as well as higher levels of pain (7).
What is it about RA that places individuals with the disease at risk for depression? In surveys, persons