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Saturday 19 October 2019
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Suicidal thought related to pain in one in ten patients with rheumatic or musculoskeletal disease

A survey has highlighted the significant impact of rheumatic and musculoskeletal diseases (RMDs) on mental health and a worrying lack of psychological care.1
 
Not enough is being done to identify mental health issues and provide the support needed to RMD  patients,” said Professor Thomas Dörner, Chairperson  of the Scientific Programme Committee, EULAR. “This survey highlights the huge importance of pain on the psychological well-being of RMD patients and the critical need to improve the support on offer. These results should act as a wake-up call to services across Europe.”
 
A survey of over 900 RMD patients revealed that pain had caused one in ten to have suicidal thoughts within the previous four weeks. Pain had also caused 58% to feel that everything was unmanageable for them.1
 
Another important finding was a reciprocal relationship between sleep and pain where 69% identified the quality of their sleep as having a negative influence on their pain. In return, two thirds of patients rarely or never feel fully rested when they wake up in the morning, with 36% taking painkillers to improve their sleep.1
 
Our study indicates that pain and poor quality of sleep have a huge impact on a patient’s daily life, especially on their mental health,” said Lene Mandrup Thomsen, the Danish Rheumatism Association, Denmark. “We are using the results of this study in our political work to help campaign for  better  treatment and support for patients with chronic pain in our  healthcare system.”
 
Of the participants, 83% have  pain  daily  or  several  times  a  week and 46%  have received strong painkillers over the  last  year. Despite a strong focus from Danish authorities on reducing their prescription, less than a quarter of respondents had been offered an alternative to strong painkillers.
 
Results of another survey, also presented at EULAR 2019, support these findings by revealing a worrying lack of psychological care for patients with rheumatoid arthritis and adult juvenile idiopathic arthritis (AJIA) in the UK.2
 
In this survey, a quarter of the 1620 people with rheumatoid arthritis or AJIA were experiencing clinical levels of anxiety or depression. Over half of these had never received a formal diagnosis. However, most concerningly half of the respondents with rheumatoid arthritis and a third of those with AJIA who had either clinical levels or a formal diagnosis of anxiety or depression had never received any psychological support.2
 
Our results highlight that, despite guidelines, many patients in the UK are not receiving the psychological support they need,” said Dr Hayley McBain,  Health  Psychologist, City, University of London, UK. “It is imperative for rheumatology services to routinely measure anxiety and depression in order to intervene before the individual is in crisis.”
 
The survey was  conducted  by  the National Rheumatoid Arthritis Society in the UK and was designed by patients and researchers. Participants were recruited via social media platforms, membership and non-membership lists and in newsletters and forums. Recruitment was focused on those diagnosed with rheumatoid arthritis or AJIA aged 18 years and over.2
 
References
  1. Mandrup Thomsen L. The influence of pain on sleep problems, mental health and use of strong painkillers among patients with arthritis. EULAR 2019; Madrid: Abstract OP0347-PARE.
  2. McBain H, Bezzant M, Bosworth A. Is psychological support reaching those in most need? a survey of people with rheumatoid arthritis and adults with juvenile idiopathic arthritis. EULAR 2019; Madrid: Abstract OP0318-HPR.