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<p>Rheumatic diseases are characterized by chronic inflammation, pain, progressive functional impairment, and substantial psychosocial burden. Depression represents one of the most common psychiatric comorbidities, occurring about twice as often in patients with rheumatoid arthritis (RA) compared with the general population. In the Salzburg Paracelsus 10,000&#xa0;Study, RA patients showed an adjusted odds ratio of 2.3&#xa0;for depressive symptoms. In addition to psychosocial stressors, inflammatory and neuroendocrine pathways may contribute to pathogenesis. Pro-inflammatory cytokines such as interleukin (IL)-6 and tumor necrosis factor (TNF)-α can alter serotonergic transmission via the tryptophan–kynurenine pathway, promoting “inflammatory depression.” Antirheumatic therapies, particularly biologics and Janus kinase (JAK) inhibitors, may improve mood indirectly through disease control, whereas glucocorticoids appear to increase the risk of affective disturbances in a&#xa0;dose-dependent manner. An integrated, multidisciplinary management approach addressing somatic, psychological, and social factors is essential to enhance quality of life, adherence, and long-term outcomes.</p>

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Rheumatische Erkrankungen und Depression

  • 期刊论文

  • 发表日期：

    2026年1月23日

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  • Mathias Ausserwinkler

摘要

Rheumatic diseases are characterized by chronic inflammation, pain, progressive functional impairment, and substantial psychosocial burden. Depression represents one of the most common psychiatric comorbidities, occurring about twice as often in patients with rheumatoid arthritis (RA) compared with the general population. In the Salzburg Paracelsus 10,000 Study, RA patients showed an adjusted odds ratio of 2.3 for depressive symptoms. In addition to psychosocial stressors, inflammatory and neuroendocrine pathways may contribute to pathogenesis. Pro-inflammatory cytokines such as interleukin (IL)-6 and tumor necrosis factor (TNF)-α can alter serotonergic transmission via the tryptophan–kynurenine pathway, promoting “inflammatory depression.” Antirheumatic therapies, particularly biologics and Janus kinase (JAK) inhibitors, may improve mood indirectly through disease control, whereas glucocorticoids appear to increase the risk of affective disturbances in a dose-dependent manner. An integrated, multidisciplinary management approach addressing somatic, psychological, and social factors is essential to enhance quality of life, adherence, and long-term outcomes.