Burden of Autoimmune Diseases on Psychological Wellbeing: Single Center Experience

Abstract

Background: Rheumatic and musculoskeletal diseases (RMDs) are chronic systemic conditions that impose significant physical and psychosocial burdens. Psychiatric comorbidities, particularly depression and anxiety, are increasingly recognized in patients with RMDs, yet remain underexplored in Middle Eastern populations.Objectives: To assess the prevalence and severity of psychiatric disorders among Egyptian patients with RMDs and to identify predictors of depression and anxiety.Methods: A cross-sectional study was conducted on 400 patients with RMDs attending Mansoura University Hospital, Egypt, from February to August 2023. Sociodemographic, clinical, and treatment data were collected. Psychiatric evaluation was performed using the Mini International Neuropsychiatric Interview (MINI), Hamilton Depression Rating Scale (HAM-D), and Hamilton Anxiety Rating Scale (HAM-A). Logistic regression analysis was applied to identify predictors of major depressive disorder and panic disorder.Results: The study population was predominantly female (94.8%) with a median age of 37.5 years. Rheumatoid arthritis and systemic lupus erythematosus were the most prevalent diagnoses. Psychiatric disorders were highly common, with panic attacks, major depressive disorder, and social anxiety being the most frequent. Depression severity was mostly mild, while marked anxiety predominated across several RMD subtypes. Logistic regression revealed that a history of psychiatric disorders during pregnancy significantly predicted major depressive disorder and panic attacks (p < 0.05).Conclusion: Psychiatric comorbidities are highly prevalent among Egyptian patients with RMDs, with pregnancy-related psychiatric history serving as a strong predictor of depression and panic attacks. Routine psychiatric screening and integrated multidisciplinary care are essential to optimize outcomes and quality of life in this patient population.