How much gloom is in groans? Depression and its determinants in Nigerian patients with knee osteoarthritis: a multi-center cross-sectional study.

Objectives: To determine the prevalence of depression and its determinants among Nigerian patients with knee osteoarthritis (OA).

Methods: Two hundred and fifty patients satisfying the American College of Rheumatology classification criteria for knee OA were recruited from five centers. Pain was assessed using Western Ontario and McMaster Universities Index (WOMAC) pain subscale, functional status was determined by Steinbrokers criteria, radiographic knee OA was graded using Kellgren-Lawrence criteria, depression was determined using the Patient Health Questionnaire (PHQ-9), sleep quality by the Pittsburgh Sleep Quality Index (PSQI), and family functioning by Family APGAR (Adaptation, Partnership, Growth, Affection, and Resolve). Factors associated with depression in KOA following bivariate analyses were adopted as independent variables in logistic regression analysis to determine the predictors of depression in KOA. The study was approved by the Ethical Review Committee of each of the study centers.

Results: The mean age of patients was 59.90 ± 10.62 years and 209 (83.6%) were females. Their mean PHQ-9 score was 4.68 ± 4.19 with 105 (42%) having depression (PHQ-9 ≥ 5). Eighty-four (80%) of patients with depression had poor sleep quality (PSQI≥ 5.0). Depression was significantly associated with poor sleep, WOMAC pain scores, medial compartment KOA, lateral compartment KOA, and patellofemoral OA. Poor sleep quality was the best predictor of depression (OR 4.555, CI (2.241-9.257), p < 0.001) followed by moderate to severe pain (OR 2.490, CI (1.119-5.542), p < 0.025).

Conclusion: Depression is common among patients with knee OA, and depression can be predicted by poor sleep quality and moderate to severe pain.