Depressive Symptom Networks in Rheumatoid Diseases.

Background and Aims: Patients with Rheumatoid diseases (AR) are at higher risk for depressive symptoms. This study aims to identify key depressive symptoms that lead to the accumulation of additional symptoms over time, using Survey of Health, Ageing and Retirement in Europe (SHARE) data from year during the follow up period 2015-2019/2020 (sample size 32,082 individuals). Methods: We applied network analysis, where nodes represent depressive symptoms by EURO-D scale and edges are weighted by odds ratios. Changes in symptom relationships were analysed by transitions between health states: "healthy," "AR only," and "AR with additional comorbidity." Results: To prevent further depressive symptom accumulation in AR patients, addressing irritability and lack of interest is crucial. In males, loss of appetite should also be targeted, while in females, depressive feelings need specific attention. Males with AR and additional comorbidities show a significant increase in symptom network density, while females have stronger associations with interest, appetite, guilt, and depression. Conclusion: AR is associated with significant changes in the structure of depressive symptom networks, varying with health progression. Attention to irritability, lack of interest, appetite, and depressive feelings is crucial for preventing further mental health declines in newly diagnosed AR patients.