Trends in the Prevalence of Osteoarthritis, Rheumatoid Arthritis, and Psoriatic Arthritis in U.S. Adults With Depression, 2005 to 2018

To investigate trends in osteoarthritis (OA), rheumatoid arthritis (RA), and psoriatic arthritis (PsA) among U.S. adults with depression from 2005 to 2018, and to evaluate their associations with demographic and metabolic factors. Cross-sectional data from seven cycles (2005-2018) of the National Health and Nutrition Examination Survey (NHANES) were analyzed. The study included 2068 adults with depression (PHQ-9 score ≥10) and 15 157 participants in total. Weighted prevalence trends were assessed using joinpoint regression, and propensity score weighting was applied to estimate arthritis risk. RA prevalence in depressed patients increased significantly from 7.8% (2005-2006) to 17.7% (2017-2018), making it the most prevalent type of arthritis. PsA prevalence declined sharply (from 7.2% to 1.7%), while the prevalence of OA remained stable (with a slight decrease from 11.7% to 10.7%). Depression was associated with a 40% higher risk of RA (OR = 1.40, 95% CI: 1.18-1.67) and a 44% higher risk of PsA (OR = 1.44, 95% CI: 1.13-1.85), but not with an increased risk of OA. RA prevalence was higher in women (18.9% vs 11.6% in men) and obese individuals (21.5% vs 11.1% in non-obese individuals). Racial disparities were observed, with non-Hispanic Black participants exhibiting the highest prevalence of RA (21.3%). The increasing burden of RA and PsA among depressed adults suggests shared inflammatory and metabolic mechanisms. Targeted screening in high-risk groups and integrated mental-metabolic care may improve early detection and outcomes.