Rheumatoid arthritis (RA) is an autoimmune inflammatory
disease, characterized by the production of numerous pro-inflammatory cytokines, such
as tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β), which
lead to pathophysiological changes in innate and acquired immunity. The existing evidence
shows that pro-inflammatory cytokines in rheumatoid arthritis impact monoaminergic
neurotransmission, neurotropic factors, and synaptic activity, which may lead to the development of depression. Materials and Methods: In our study, we explored the association
between TNF-α and IL-6, disease activity, and the degree of depression in patients with
RA. The association between TNF-α and IL-6 and the Beck and Hamilton depression scales
was analyzed in a group of 116 RA patients with depression. We investigated the same
correlation in 45 patients with primary depression who represented the control group.
Results: A Spearman test showed that IL-6 levels had a positive association with the Beck
and Hamilton scales (p < 0.05) and that TNF-α had a positive association with the Hamilton
scale (p < 0.05). Also, the Hamilton depression scale was the more sensitive scale in the
detection of depressive symptoms. Conclusions: Our study indicates that elevated values
of pro-inflammatory cytokines are associated with the degree of depression in patients
with RA. Future preclinical and clinical studies will contribute to a better understanding of
the pathophysiological mechanism of depression in patients with RA and may serve as the
basis for new treatment modalities. By detecting depression promptly, with the help of the
HAM-D as the more sensitive scale, we could influence the future modality of treatment,
and with a multidisciplinary approach, we could ensure an improvement in the quality of
life of patients with RA.
