Impact of the COVID-19 Pandemic on the Mental Health of Canadians Living With Rheumatoid Arthritis

A study to measure the psychological consequences that COVID-19 had on people with

rheumatoid arthritis.

The Problem

For Canadians with rheumatoid arthritis, pandemic-related stress was made worse by concerns about increased risk of COVID due to medications that suppress the immune system, delayed and uncertain access to vaccines, periodic lockdowns, and initial uncertainty about access to medications.

The Solution

Understanding the emotional impact of the pandemic may help us better anticipate and address the mental health needs of people living with rheumatoid arthritis.


What the Study will do

This research compares trends in the prevalence of anxiety and depression prior to, during, and will continue after, the COVID-19 pandemic in people with rheumatoid arthritis, with and without a prior history of mood disorders.

The Research Study

Using survey information from CATCH (Canadian Early Arthritis Cohort), a large pan-Canadian cohort of adults living with rheumatoid arthritis (RA) followed over many years, this study compared the symptoms of depression and anxiety before and during the first 22 months of the COVID-19 pandemic in 1644 patients. Because participants provide information about their physical, emotional, and social health at each visit, the investigators were able to evaluate mood in the year prior to and during the pandemic. They will continue to do so during the remainder of and after the pandemic.

They found that more than 1 in 5 reported symptoms of anxiety and depression prior to and after the onset of the COVID-19 pandemic. Whereas in the general Canadian population, the number of Canadian adults reporting depression more than doubled in the first few months of the pandemic but declined fairly rapidly afterwards, emotional distress was not diminished over time in patients with RA. Adults reporting a prior history of mood disorders were more than twice as likely to report emotional distress with depression peaking early in the pandemic and anxiety growing with each successive wave.

The results suggest that it may be important for rheumatology team to ask patients about their lifetime history of anxiety and depression as previous episodes may be an important marker of increased vulnerability and recurrence in RA patients, particularly during the pandemic.

Research Scientist

Susan Bartlett, PhD, Licensed Psychologist

Susan Bartlett, PhD, Licensed Psychologist

Research Scientist

Susan Bartlett, PhD, is a Professor of Medicine in the Divisions of Clinical Epidemiology, Rheumatology, and the Respiratory Epidemiology and Clinical Trials Units at McGill University and the McGill University Health Centers. Dr. Bartlett is a clinical psychologist by training with longstanding research and clinical interests in patient-centered research and care and meaningful patient engagement in research.

She serves as Co-Principal Investigator on three awards from the Patient Centered Outcomes Research Institute in the US. Other work has been funded by the CIHR, the National Institutes of Health, the Arthritis Foundation, the American Thoracic Society and others. Dr. Bartlett is a steering committee member of the National Institutes of Health PROMIS International Initiative. Patient Reported Outcomes Measurement Information System (PROMIS®) is a system of reliable and responsive measures of patient–reported health status for physical, mental, and social well–being.

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