Osteoarthritis and Depression Comorbidity and Intervention

Osteoarthritis (OA), the most common form of arthritis, is a leading cause of debilitating pain and disability, affecting> 32 million in the U.S. alone. The prevalence and incidence of OA have been continuously increasing due to increases in lifespan and obesity.The number of OA patients is expected to rise to over 78 million in the U.S. by 2040. In particular, OA has been a substantial burden among Veterans of the U.S. Armed Forces due to the high physical demands of their daily routines. More recently, serious concerns have been raised regarding OA-related chronic comorbid health conditions. For example, individuals with OA have a 2.5-times greater risk of having three or more other chronic diseases. Compared to civilians, veterans are far more vulnerable to a chronic comorbid health condition - more than a third of veterans suffer from at least two such chronic diseases (e.g., OA and depression). In particular, OA patients show a higher prevalence of the devastating symptoms of depression and anxiety than those without OA. Worse, the synergistic adverse effects of OA and depression have been recognized when they have comorbid conditions. Arthritic conditions and depression comorbidity magnify the persistent joint pain, which, in turn,worsens the depression. As OA is the most prevalent form of arthritis, depression is the most prevalent psychiatric disorder, ranking in the top five leading causes of disability worldwide. Every day, 17.6 U.S. veterans commit suicide, primarily due to the ramifications of untreated depression. These reports indicate an urgent unmet need to improve treatment strategies to manage OA symptoms and prevent depression, a comorbid chronic disease in OA patients.