Study: Rheumatologists see need for, lack skills to address patients’ mental health needs

Study: Rheumatologists see need for, lack skills to address patients’ mental health needs

December 1, 2015

A “a gap in care provision” may exist among rheumatologists as a recent survey indicated rheumatologists recognize a need to address mental health issues in patients with rheumatic diseases, but may not have the skills or time to treat patients in need of mental health services.

Researchers mailed a questionnaire to 470 practicing rheumatologists in California. Of recipients, 226 (55%) responded and met criteria for analysis. The questions were related to demographics, practice characteristics, attitudes toward mental health issues and practices associated with depression.

Logistical regression models were used to assess the personal and practice characteristics with their usual strategies for addressing depression, including prescribing antidepressants or referrals to either primary care or psychiatric professionals.

About half (51%) of respondents reported that at least half of their patients experienced depression and many were untreated. Addressing mental health issues was reported by 99% of respondents during some visits, and 69% reported the issue was raised by the physician. Nine percent reported the use of a formal screening tool.

Rheumatologists surveyed were equally likely to refer patients to primary care or psychiatric professionals or to prescribe antidepressants, and 60% of respondents reported the application of all three strategies with at least half of patients. A greater number of weekly visits and a greater proportion of patients with fibromyalgia were associated with prescribing antidepressants in logistical regression models.

“Our findings point toward a gap in care provision,” the researchers wrote. “Rheumatologists see a great need for mental health services, but too often lack the skills and time to address mental health issues.” - by Shirley Pulawski


Heiman HE, et al. Paper #129. Presented at: American College of Rheumatology Annual Meeting; Nov. 7-11, 2015; San Francisco.

Disclosures: Heiman reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.

LUpus Patients Understanding & Support (LUPUS) was created in 2000 to address the unmet psychological needs of patients-affected-by-systemic lupus erythematosus, lupus variant conditions and the antiphospholipid antibody (Hughes) syndrome.

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  • Luckily, my pain clinic has a psychologist to work with. We see Dr. then psych. so we are covered in two ways. Yet it is not my therapy of choice. He mostly wants to talk about health and I want to talk about other things, growing while ill, learning to live with it in balance of some kind, how to find the right kind of help, an assistant, etc.

  • I completely understand what you mean. Is it possible for you to get a referral to see another therapist? This would be your best option. But why don't you try telling him what YOU need? I assume he is a clinical psychologist.

    It is not a good idea to have more than one "therapist" partly because two people work differently (different theoretical orientations) and this can cause confusion - like playing off between 2 parents!

    On the other hand, I understand what you are saying.

    LUpus Patients Understanding & Support (LUPUS) specialise in psychological support online and you are welcome to join the LuPUS Message Board. I will send you a private message with the details.

    We have our in-house psychotherapist/counsellor.

    You can contact me there or email me: roz [at] [lupus-support] [dot] [org] [dot] [uk]

    With good wishes,


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