Depression in rheumatic and musculoskeletal diseases; tip of the iceberg andthe most neglected part of management; A cross-sectional study.


  • Syed Hassan Mustafa Ayub Teaching Hospital Abbottabad.
  • Saqib Adnan Lady Reading Hospital Peshawar.
  • Taimur Khan University Hospital Wishaw Lanarkshire UK.
  • Waqar Hayat Lady Reading Hospital Peshawar.
  • Talha Durrani Khyber Teaching Hospital Peshawar.
  • Farah Iqbal Lady Reading Hospital Peshawar.



Depression, Rheumatoid Arthritis, Rheumatology


Objective: To investigate the frequency of Depression in Patients with Rheumatic and Musculoskeletal diseases with particular emphasis on gender and compliance to treatment. Study Design: Descriptive, Cross-sectional study. Setting: Department of Rheumatology at Lady Reading Hospital, Peshawar. Period: August 2020 to February 2021. Material & Methods: A total of 189 patients were assessed with their detailed history, examination, and lab data collected. Depressive symptomatology was evaluated using DSM – 4 criteria . SPSS 26 was utilised for data analysis, and a p-value of<0.05 was considered statistically significant. Results: 131 (69.3%) were female and 58 (31.7%) were male patients. Seropositive Rheumatoid Arthritis ranked the highest concerning the diagnosis with 128 cases (68.25%). Methotrexate was the most commonly used drug with 134 (70.9%) patients receiving it. A total of 169 (89.4%) patients had Depressive disorder, with females outnumbering males, a finding reaching statistical significance (p=0.04). Conclusion: Undiagnosed Depression is common in patients affected by Rheumatic and Musculoskeletal diseases, especially among the female population. Routine screening for depressive symptoms with subsequent referral to the mental health service may serve detection of this comorbidity and improve patient outcomes.

Author Biographies

Syed Hassan Mustafa, Ayub Teaching Hospital Abbottabad.

MBBS, FCPS Med, FCPS (Rheum), Consultant Physician, 

Saqib Adnan, Lady Reading Hospital Peshawar.

MBBS, FCPS Med, FCPS (Rheum), Assistant Professor and HOD Division of Rheumatology, 

Taimur Khan, University Hospital Wishaw Lanarkshire UK.

MBBS, MRCP (Psych), Consultant Psychiatrist, 

Waqar Hayat, Lady Reading Hospital Peshawar.

MBBS, FCPS (Med), Assistant Professor Emergency Medicine, 

Talha Durrani, Khyber Teaching Hospital Peshawar.

MBBS, Postgraduate Trainee Medicine Medicine, 

Farah Iqbal, Lady Reading Hospital Peshawar.

MBBS, Postgraduate Trainee Dermatology,