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Rheumatoid arthritis and depression aninflammatoyperspective

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www.thelancet.com/psychiatryPublishedonlineOctober23,2018http://dx.doi.org/10.1016/S2215-0366(18)30255-41ReviewRheumatoidarthritisanddepression:aninflammatoryperspectiveLouisNerurkar,StefanSiebert,IainBMcInnes,JonathanCavanaghThecoexistenceofimmune-mediatedinflammatorydiseaseswithdepressionhaslongbeenrecognised.Datathatillustratetheintimateassociationsbetweenperipheralandbrainimmuneresponsesraisethepossibilityofsharedpathophysiologicalmechanisms.Theseassociationsincludethenegativeeffectsofproinflammatorycytokinesonmonoaminergicneurotransmission,neurotrophicfactors,andmeasuresofsynapticplasticity.Theevidencesupportingthisassociationisaccumulatingandincludesfindingsfromclinicaltrialsofimmunomodulatorytherapy,indicatingthattheseinterventionscanprovidebenefitstomentalhealthindependentofimprovementsinphysicaldiseasescores.InthisReview,weassessthisevidenceinrelationtorheumatoidarthritisanddepression,withafocusoninnateimmuneandmolecularresponsestoinflammation,anddiscussthechallengesofassessi

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