The Role of Gender in Depression Among Patients With Rheumatoid Arthritis Pain

Introduction Rheumatoid arthritis (RA) is a chronic autoimmune disease marked by persistent joint pain, fatigue, and functional impairment. Depression is common in RA and may be driven, in part, by the burden of chronic pain. While both RA and depression are more prevalent in women, it remains unclear whether gender influences depression severity among RA patients. This study aimed to assess whether gender is associated with depression scores in individuals with RA, while considering the potential role of chronic pain as a key contributor to psychological distress. Methods We used data from the National Health and Nutrition Examination Survey (NHANES) 2021–2023 to identify adults with self-reported RA. Depression severity was measured using the PHQ-9, and a multivariable linear regression model was employed to assess the association between gender and depression scores, adjusting for age, race, education, and marital status. Results Among 419 individuals with RA, 58.7% were female. While females had slightly higher rates of moderate to moderately severe depression, gender was not significantly associated with PHQ-9 scores (β = 0.74, p = 0.335). Marital status was the only variable significantly associated with depression scores, with unmarried individuals reporting higher levels of depressive symptoms (β = 1.67, p = 0.029). The high prevalence of depressive symptoms highlights the likely influence of chronic pain in driving psychological burden across all demographic groups. Conclusion Depressive symptoms are common among patients with RA, but gender differences may be diminished by the unifying effect of chronic pain. These findings underscore the importance of addressing chronic pain as a central component in managing RA-related depression, and call for integrated care approaches that target both physical and emotional well-being.