Video: Every Case Tells a Story| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

  • Conditions
    • Axial Spondyloarthritis
    • Gout and Crystalline Arthritis
    • Myositis
    • Osteoarthritis and Bone Disorders
    • Pain Syndromes
    • Pediatric Conditions
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Sjögren’s Disease
    • Systemic Lupus Erythematosus
    • Systemic Sclerosis
    • Vasculitis
    • Other Rheumatic Conditions
  • FocusRheum
    • ANCA-Associated Vasculitis
    • Axial Spondyloarthritis
    • Gout
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Systemic Lupus Erythematosus
  • Guidance
    • Clinical Criteria/Guidelines
    • Ethics
    • Legal Updates
    • Legislation & Advocacy
    • Meeting Reports
      • ACR Convergence
      • Other ACR meetings
      • EULAR/Other
    • Research Rheum
  • Drug Updates
    • Analgesics
    • Biologics/DMARDs
  • Practice Support
    • Billing/Coding
    • EMRs
    • Facility
    • Insurance
    • QA/QI
    • Technology
    • Workforce
  • Opinion
    • Patient Perspective
    • Profiles
    • Rheuminations
      • Video
    • Speak Out Rheum
  • Career
    • ACR ExamRheum
    • Awards
    • Career Development
  • ACR
    • ACR Home
    • ACR Convergence
    • ACR Guidelines
    • Journals
      • ACR Open Rheumatology
      • Arthritis & Rheumatology
      • Arthritis Care & Research
    • From the College
    • Events/CME
    • President’s Perspective
  • Search

Experts Discuss Rheumatologists’ Role in Treating Depression, Anxiety and Psychological Comorbidities in Their Patients

Larry Beresford  |  Issue: December 2017  |  December 17, 2017

Dr. Evers says she sometimes gets asked to consult with patients online via e-coaching. “We did a randomized controlled trial in patients with RA that showed it is as effective as a face-to-face encounter.” There are a lot of Web-based resources for self-help, she adds, although unguided sites are not as helpful as those with guides, particularly for their impact on daily life adjustment.

Dr. Matcham says, “A lot of what we use is self-help, which can be effective with lower levels of distress. But I also think it’s important to train rheumatology staff in basic mental health skills, such as how to manage conversations about mental health concerns.” She says rheumatologists also must “know what local resources are available to support their patients.” Sometimes in the UK health system, medical services will apply for money for a part-time psychologist as part of the clinical team. “That’s a really good model; it breaks down stigma and reinforces the perception that mental health and physical health are intertwined.”

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Every rheumatologic group ideally would have a behavioral specialist embedded, freeing the rheumatologists to focus on treating their patients’ rheumatologic diseases, Dr. Hassett says. “Most doctors can at least get a mental health evaluation ordered. Some rheumatologists [may] feel comfortable treating a mild depression or anxiety and writing related prescriptions, although typically it is easier to send the patient back to the primary care physician, who may be more comfortable with handling psychiatric conditions. The important thing is to recognize the patient who is depressed and anxious and likely to do more poorly,” she says. “You don’t need a psychologist per se; other professionals have training in behavioral interventions, for example social workers, and those practitioners can bill for their services.”

The Importance of Attitude

Dr. Evers’ research on psychoneurobiology in chronic inflammatory conditions has pointed her toward studying the placebo effect—not merely that some patients can be tricked with a sugar pill, but that expectations of the patient and physician have an effect on response to treatment, both positive and negative. “Our research tells us the placebo effect has a major role. If there are negative expectations from treatment, there will be more side effects. But if patients are satisfied with their treatment, they will have a more positive experience and greater adherence to their treatment.”

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

How can doctors optimally utilize the placebo effect? “We are preparing a publication on guidelines with two major recommendations. First is the importance of transparently informing patients about the implications of the placebo effect—and that their expectations for treatment could play a huge role in the treatment’s efficacy,” Dr. Evers says. Patients must be informed about the placebo effect, but how they are told also has a role.

Page: 1 2 3 4 5 6 | Single Page
Share: 

Filed under:ConditionsPain SyndromesPractice Support Tagged with:anxiety disordersbehaviorcognitivecomorbiditiesDepressionfatigueFibromyalgiaLupusManagementMental Healthpatient carepsychologicalquality of lifeRARheumatoid arthritisrheumatologic conditionsrheumatologistrheumatologySLEtherapyTreatment

Related Articles

    7 Tools to Identify Depression

    August 1, 2014

    Why screening for depressive symptoms in patients with arthritis is needed

    Depression in Rheumatoid Arthritis

    November 1, 2012

    Examining the psychological and health-related comorbidities of rheumatoid arthritis patients with depression

    Depression & Anxiety Linked to Poor Rheumatoid Arthritis Outcomes

    September 18, 2015

    NEW YORK (Reuters Health)—Rheumatoid arthritis patients with depression and anxiety symptoms may have worse outcomes and poorer response to prednisolone, a secondary analysis of the CARDERA trial has found. “The strength of association between depression/anxiety and disease activity outcomes and treatment response warrants routine screening,” the study’s lead author Faith Matcham at King’s College London…

    Targeted Rheumatoid Arthritis Treatment Does Not Improve Mental Health

    June 14, 2018

    NEW YORK (Reuters Health)—Effective pharmacotherapy of rheumatoid arthritis (RA) is not associated with meaningful improvements in mental health, according to a systematic review and meta-analysis. “We were surprised by the small effect sizes for mental-health outcomes across all of the treatments included in this review, but particularly for the anti-TNF versus disease-modifying antirheumatic drug (DMARD)…

  • About Us
  • Meet the Editors
  • Issue Archives
  • Contribute
  • Advertise
  • Contact Us
  • Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1931-3268 (print). ISSN 1931-3209 (online).
  • DEI Statement
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences