Evidence map›Paper›PMID 41331562›Full record

ArticleBMC public health2025

Mediators of the association between rheumatoid arthritis and depression.

Shate Xiang, Danyi Xu, Kepeng Yang, Chao Hu, Jingjing Zhang, Mengge Zhang, Runyu Chang, Xinghong Ding

Abstract readMulticenter Study
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Shate Xiang *School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
Danyi Xu *Department of Rheumatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China.
Kepeng Yang *Department of Rheumatology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, China.
Chao Hu *School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
Jingjing ZhangSchool of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
Mengge ZhangSchool of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
Runyu ChangSchool of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
Xinghong DingSchool of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China. dxh@zcmu.edu.cn.ORCID http://orcid.org/0000-0001-7090-9445

Funding

2024 Zhejiang Province College Students Science and Technology Innovation Activity Plan 2024R410C067Bureau and provincial joint construction of science and technology plan project GZY-ZJ-KJ-23009Zhejiang Provincial Natural Science Foundation of China under Grant ZCLMS25H2705
6 · The paper itself

Abstract

objectiveThe etiology of rheumatoid arthritis (RA) comorbid with depression is poorly defined. This study aims to investigate the mediating factors in RA co-morbid depression.

methodsThrough the multicenter, cross-sectional study method, the variables that may become mediating factors were collected. Depression was assessed with the Patient Health Questionnaire-9 (PHQ-9). The generalized linear model and Structural Equation Model (SEM) were used to explore the mediators. Mendelian randomization (MR) was employed to validate the results.

resultsA total of 746 subjects were enrolled, including 506 RA patients and 240 non-RA patients. Correlation analysis showed that Health assessment questionnaire disability index (HAQ-DI) (β = 0.04; 95%CI = 0.01, 0.07; P = 0.002), Fatigue Self-Assessment Scale (FSAS) (β = 0.21; 95%CI = 0.19, 0.23; P < 0.0001), and Pittsburgh sleep quality index (PSQI) (β = 0.26; 95%CI = 0.19, 0.33; P < 0.0001) were positively correlated with RA co-morbid depression. Among these, FSAS was a mediator in the causal pathway from RA to depression (Effect estimate = 0.39; 95% CI = 0.30, 0.53). MR analysis supports the mediating role of frailty. In addition, HAQ-DI indirectly mediated the effect of RA on depression through a sequential pathway involving ESR and FSAS, serving as another key factor in this causal pathway.

conclusionFatigue and disability are primary mediators contributing to the comorbidity of RA and depression. Therefore, targeting these mediating factors through clinical interventions may represent an effective strategy for preventing and treating depression in this population.

Indexed as

Arthritis, RheumatoidDepressionComorbidityCross-Sectional StudiesFatigueFemaleHumansMaleMendelian Randomization AnalysisMiddle AgedSurveys and QuestionnairesCorrelational analysesDepressionMendelian randomizationRheumatoid arthritisStructural equation model

Identifiers

PMID41331562
PMCPMC12673782

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.