Study finds increased psychological comorbidities in patients with osteoarthritis

According to data from the German Federation Statistical Office, published in Scientific Reports, there was a 37.8% increase in the prevalence of psychological comorbidities among patients with coxarthrosis and a 17.9% increase among those with gonarthrosis between 2009 and 2019. Dr. Nike Walter and their team reported that affective disorders were the most prevalent psychological disorder diagnosed over the years.

The cross-sectional study investigated the prevalence of osteoarthritis, coxarthrosis, and gonarthrosis in patients with psychological disorders. In 2019, there were 138,232 reported cases of coxarthrosis, compared to 119,542 cases in 2009, for a total of 203.7 cases per 100,000 Germans (incidence rate ratio (IRR) = 1.13). There was a 5.7% decrease in gonarthrosis cases between 2009 and 2019, with 152,160 patients in total, or 224.2 cases per 100,000 residents (IRR – 0.94). According to the study, the percentage of coxarthrosis patients with relevant psychological diagnoses increased by 37.8% between 2009 and 2019, while the risk raised by 17.9% in patients with gonarthrosis. Affective disorders were the main psychological comorbidity present in patients with both conditions.  The prevalence of affective disorders noted in coxarthrosis and gonarthrosis patients with comorbidities were 47.6% and 57.5%, respectively.

A 2017 study has also evaluated the presence of mental disorders in patients with chronic somatic diseases, including coxarthrosis. The study included 76 patients from Mechnikov Regional Clinical Hospital in Dnipro City. Among the 51 patients with coxarthrosis, forms of borderline mental illnesses were identified, including depressive disorder (24.8%), neurasthenia (16.2%), anxiety and phobic disorders (18.1%), and personality disorders (7.6%). Clinically recognized forms of mental illnesses were found in 33.3% of the individuals. Depression was the most common syndrome among these illnesses, with 24.8% of individuals, followed by anxiety and phobias (15.0%), asthenia (10.4%), and hypochondriacs (7.5%). In conclusion, this study highlights the influence of pain syndrome and borderline mental disorders in coxarthrosis patients.

Mental disorders in individuals with coxarthrosis and gonarthrosis can significantly increase the severity of the condition, decrease the likelihood of adaptation, and worsen the course and outcome of the primary disease. Therefore, screening tools, preventative measures, and psychological support are warranted in the treatment of osteoarthritis patients with psychological comorbidities.


  1. Walter N, Hinterberger T, Szymski D, Alt V, Rupp M. Psychological comorbidities in osteoarthritis in Germany. Scientific Reports. 2023 Feb 18;13(1):2905.
  2. Spirina ID, Fedenko ES, Rokutov SV, Kazakov VY, Shornikov AV. Mutual influence of intensity of pain syndrome and borderline mental disorders in patients with coxarthrosis. Regulatory Mechanisms in Biosystems. 2017 Feb 15;8(1):84-90.