Appearance and physical disability are risk factors for depression in people afflicted with rheumatoid arthritis, researchers report. With systemic lupus erythematosus, commonly known as just lupus, only appearance seems to predict depression.

Physical deformities, particularly of the hands and feet, can develop with rheumatoid arthritis, whereas skin rashes and other lesions can occur with lupus, Dr. Louise Sharpe, from the University of Sydney in Australia, and colleagues note in the medical journal Arthritis & Rheumatism.

Although few studies have looked at body image concerns, there is evidence that women with these disorders have a poorer body image than unaffected women, the team notes.

The focus of their study was to evaluate the link between physical appearance concerns and psychological distress in patients with lupus and rheumatoid arthritis.

The study involved 60 patients with lupus, 44 with chronic rheumatoid arthritis, and 53 with recent-onset rheumatoid arthritis. They completed a variety of questionnaires regarding their physical and mental health.

Increased psychological distress was noted in all three groups. Moreover, 53 percent of lupus patients reported feeling unattractive because of their disease compared with just 30 percent and 34 percent of patients with chronic and new-onset rheumatoid arthritis.

As noted, appearance concerns raised the risk of depression in both lupus and arthritis patients, whereas physical disability only had an effect in the latter group. These factors did not influence the occurrence of anxiety in either group.

“What this study highlights is that appearance concerns and depression are closely interrelated,” the authors conclude, “and that it is important that they be considered together in the psychological functioning of patients with rheumatic disease.”

SOURCE: Arthritis & Rheumatism, March 2007.