A new study has suggested that clinical depression can make the symptoms of knee arthritis worse than what is evident on X-rays.
It found that elderly people with mild to moderate knee arthritis are especially affected by depression.
"Knee osteoarthritis is a common cause of pain and impairment in older adults," said Tae Kyun Kim, study author and director of the Division of Knee Surgery and Sports Medicine at Seoul National University Bundang Hospital`s Joint Reconstruction Center.
"Often, the level of arthritic symptoms reported by patients is much more severe than what is represented by X-rays, which can make it difficult for the doctor to treat," he added.
Kim said that the results of the study indicate that depression could play a major role in the way patients experience the symptoms of knee arthritis, and that even when X-rays show the arthritis is not severe, patients with depression may report significant pain.
The study included 660 men and women aged 65 years or older who were evaluated for the severity of their knee arthritis on X-rays, as well as symptom severity.
Interviews and questionnaires were used to assess coincident depressive disorders.
The researchers found the levels of pain attributed to knee arthritis were higher in patients whose X-rays indicated greater joint damage.
However, they also found depressive disorders were associated with an increase in pain in patients with mild to moderate knee arthritis, even when X-rays did not show significant joint damage.
"When evaluating the results of this study, the contribution of depression to knee osteoarthritis symptoms was almost as important as the damage indicated on X-rays," said Kim.
"The relationship between pain and depression suggests that both should be considered by physicians when treating patients with knee osteoarthritis, particularly in those with X-rays not indicating severe damage to the joint," he added.
The study appears in the Journal of Bone and Joint Surgery.