Eligibility and Screening

Subthreshold depressive symptoms can measurably elevate disease activity scores. The study used clinician-administered M.I.N.I. modules aligned with DSM-IV and ICD-10 criteria. Psychological distress is assessed with K6 and suicidality with the Patient Safety Screener. Potentially eligible patients will be identified from surgery waitlists and contacted 4 to 6 months before surgery. Screening includes mental health assessment to identify people who may be at risk of psychological harm from tapering. Routine screening should combine structured diagnostic interviews with symptom-severity questionnaires. The study argues for systematic mental health assessment in routine rheumatology practice.