Depression and Anxiety as Predictors of Quality of Life in Osteoarthritis Patients.

Abstract

Background:  Osteoarthritis (OA) is among the most common chronic joint disorders, which not only causes pain and disability, but also adversely impacts the psychological health and the quality of life (QoL). Depression and anxiety are commonly reported in OA patients, but their use as predictors of QoL has not been fully explored in Pakistan. The purpose of this study was to investigate whether depression and anxiety have a predictive effect on QoL in OA patients.

Methods:  A cross-sectional study was conducted between July and August 2025 among 300 adult OA patients recruited through community health centers, outpatient clinics in Sargodha and Lahore, Pakistan, and orthopaedic departments. The tools used to collect data were a structured questionnaire, consisting of the Hospital Anxiety and Depression Scale (HADS) and the Short Form-36 Health Survey (SF-36). Descriptive statistics, Pearson correlation, independent t-tests, one-way ANOVA, chi-square tests, and multiple linear regression were used to evaluate relationships between psychological and QoL.

Findings: The study population consisted primarily of female patients (N = 240, 80%), with half being older than 65 years (N = 150, 50%). There was a significant correlation between anxiety and depression with lower QoL (r = -0.356 and r = -0.482, respectively; p < 0.001). Women were found to have average anxiety and depression and a low QoL score relative to that of men (p < 0.001). Older age was linked to greater depression and anxiety and less QoL (p < 0.001). Regression analysis revealed a significant predictor of poor QoL as depression (β = -0.245, p = 0.001), anxiety (β = -0.145, p = 0.003), older age, female gender, longer duration of disease, location of OA, and current treatment.

Conclusion: Depression and anxiety became powerful predictors of poor QoL among OA patients, and depression had a more substantial effect. The results emphasise the need to integrate psychological evaluation and care into the regular OA treatment to enhance patient outcomes. Both physical and mental health care should be given on a holistic basis to improve the QoL of this population.