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The following questionnaires were used: Beck Depression Inventory (BDI), painDETECT test, Perceived Stress Questionnaire, fatigue questionnaire (FACIT), Health Assessment Questionnaire Disability Index (HAQ-DI), and the SF\u201336 questionnaires (Short-Form 36 Health Survey). Disease activity score (DAS 28-CRP) and visual analogue scale (VAS) for pain were also evaluated. Statistical analysis is based on comparison of means and proportions. Statistical significance for non-normal data was evaluated by non-parametrical tests.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Depressive symptoms were more prevalent in the Brazilian sample (44% vs 22.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.025). Compared to German patients, the Brazilian ones also experienced more pain (current pain status on VAS: 4.67\u2009\u00b1\u20093.4 vs 3.67\u2009\u00b1\u20092.31 respectively, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), were physically more limited (1.89\u2009\u00b1\u20091.85 vs 1.01\u2009\u00b1\u20090.75, <jats:italic>p<\/jats:italic>\u2009=\u20090.012), and had higher C-reactive protein levels (7.78\u2009\u00b1\u200918.3 vs 5.82\u2009\u00b1\u200910.45, <jats:italic>p<\/jats:italic>\u2009=\u20090.028). Despite receiving a more intensive treatment, German patients presented similar disease activity when compared to Brazilian patients (DAS28-CRP: Brazil 3.4\u2009\u00b1\u20091.5 vs Germany 3.3\u2009\u00b1\u20091.3, <jats:italic>p<\/jats:italic>\u2009=\u20090.307).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Depressive symptoms are frequent in RA patients from different countries and interact with psychological disorders and the experience of pain. They contribute negatively to their well-being suggesting the need for psychoeducational strategies.<\/jats:p>\n                <jats:p><jats:table-wrap><jats:table><jats:tbody>\n                      <jats:tr>\n                        <jats:td colspan=\"2\"><jats:bold>Key Points<\/jats:bold>\u2022 <jats:italic>New psychoeducational strategies for RA management.<\/jats:italic>\u2022 <jats:italic>Higher inflammation marker in rheumatoid arthritis patients is associated with depression.<\/jats:italic>\u2022 <jats:italic>Medical treatment in RA influences depressive symptoms.<\/jats:italic>\u2022 <jats:italic>Depressive symptoms are dependent on population group.<\/jats:italic>\u2022 <jats:italic>High disease activity is related to depression.<\/jats:italic><\/jats:td>\n                      <\/jats:tr>\n                    <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10067-020-05470-0","type":"journal-article","created":{"date-parts":[[2020,10,26]],"date-time":"2020-10-26T06:02:50Z","timestamp":1603692170000},"page":"1779-1787","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Impact of clinical and psychological factors associated with depression in patients with rheumatoid arthritis: comparative study between Germany and Brazil"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6688-2155","authenticated-orcid":false,"given":"Harriet","family":"Morf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldo","family":"da Rocha Castelar-Pinheiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Beatriz","family":"Vargas-Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Baerwald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Seifert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,26]]},"reference":[{"issue":"10055","key":"5470_CR1","doi-asserted-by":"publisher","first-page":"2023","DOI":"10.1016\/S0140-6736(16)30173-8","volume":"388","author":"JS Smolen","year":"2016","unstructured":"Smolen JS, Aletaha D, McInnes IB (2016) Rheumatoid arthritis. 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