Depressão e ansiedade são fatores de risco para Artrite Reumatoide? uma revisão sistemática

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that primarily affects the joints. Evidence suggests that cytokines, such as IL-1, IL-6, and TNF-α, cross the blood-brain barrier and impact the functioning of the Central Nervous System, contributing to the emergence of psychological disorders, such as depression. On the other hand, responses of the Central Nervous System, can lead to an increase of these cytokines. Considering this connection, the objective of this study was to conduct a systematic review that answers the following research question: Can psychological disorders of depression and/or anxiety be considered risk factors for the development of RA? For this, a standardized search was performed in the Medline/PubMed, Embase, Scopus, Web of Science, PsycINFO, Cochrane Library, LILACS, and PROQUEST databases. Two reviewers independently selected the studies and assessed their methodological quality using the Newcastle-Ottawa Scale and the JBI Critical Appraisal tool Checklist for Cohort and Case control studies. As a result, an observational cohort study with 231 participants with seropositive arthralgia was included. The research assessed the association between depressive state, daily stressors, coping strategies, social support and the development of RA. No statistically significant association was found between depressive state and risk of developing the disease. The result of the methodological quality assessment was low, due to the absence of a control group without exposure and the failure to consider confounding factors. Despite the limitation of the available evidence, the topic remains relevant given the evidence that psychological disorders may predispose to the development of RA. Future studies, with greater methodological rigor and standardization of diagnostic criteria, are needed to elucidate this relationship and support integrated clinical and biopsychosocial approaches. The protocol for this review was registered with the International Prospective Registry of Systematic Reviews (PROSPERO), under number CRD42023404169, and published in the Electronic Journal Scientia Amazonia.