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Mental Health Screening in Rheumatology: The Overlooked Connection – Nursing Science
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id="primary"> <main class="site-main" id="main"> <article id="post-125" class="post-125 post type-post status-publish format-standard has-post-thumbnail hentry category-rheumatology tag-anxiety tag-depression tag-integrated-care tag-mental-health-screening tag-musculoskeletal-complaints tag-prime-md tag-psychiatric-disorders tag-rheumatology" itemtype="https://schema.org/CreativeWork" itemscope> <div class="inside-article"> <div class="featured-image page-header-image-single "> <img width="1200" height="628" src="https://nursing-science.com/archive/wp-content/uploads/2024/10/posters-01-min-scaled-e1729857953562.jpg" class="attachment-full size-full" alt="" itemprop="image" decoding="async" fetchpriority="high" /> </div> <header class="entry-header"> <h1 class="entry-title" itemprop="headline">Mental Health Screening in Rheumatology: The Overlooked Connection</h1> <div class="entry-meta"> <span class="posted-on"><time class="updated" datetime="2024-10-25T17:35:59+05:30" itemprop="dateModified">October 25, 2024</time><time class="entry-date published" datetime="2024-10-24T12:45:20+05:30" itemprop="datePublished">October 24, 2024</time></span> <span class="byline">by <span class="author vcard" itemprop="author" itemtype="https://schema.org/Person" itemscope><a class="url fn n" href="https://nursing-science.com/archive/author/nursing-science/" title="View all posts by nursing-science" rel="author" itemprop="url"><span class="author-name" itemprop="name">nursing-science</span></a></span></span> </div> </header> <div class="entry-content" itemprop="text"> <p><span style="font-weight: 400;">Rheumatology, being a medical specialty that deals with the diagnosis and treatment of rheumatic diseases, has for a long time incorporated the importance of musculoskeletal pain, particularly arthritis and autoimmune diseases. However, one of the usual and frequently neglected aspects of rheumatology is the high rate of psychiatric diseases in patients with musculoskeletal pain. It is established that mental health and physical health are correlated; however, assessment of mental health is seldom incorporated into the routine rheumatologic patient examination. Such omissions result in wrong diagnoses, delayed treatment, and therefore unsatisfactory client results. Regarding rheumatology, special emphasis should be placed on the significance of mental health assessment since it is instrumental in the general approach to patients, the identification of correct diagnoses, and in enhancing the quality of life in identified individuals. This blog aims to bring attention to the association between psychiatric disorders and rheumatologic conditions and to stress the importance of introducing systematic mental health assessment in rheumatology practice.</span></p> <h3><b>The Epidemiology of Psychiatric Diagnosis in Rheumatology</b></h3> <p><span style="font-weight: 400;">Many who attend rheumatology clinics have chronic pain in the joints and muscles, which is often undiagnosable, thus being a source of frustration to the patient and the healthcare provider. Some past research has demonstrated that a large number of these patients also have psychiatric disorders; increased rates are recognized in comparison to those observed in general medical clinics. Such patients often have anxiety disorders, depression, and somatoform disorders. Depression and other psychiatric disorders’ incidence in rheumatology patients with BPMs may be as high as 40%, 2–3 times higher than in similar patients in primary care.</span></p> <p><span style="font-weight: 400;">It may be postulated that symptoms of psychiatric disorders may enhance rheumatology patients’ perception or reporting of musculoskeletal pain and disability. For example, pain may affect those patients who have anxiety or symptoms of depression, as these patients would have higher pain sensations, more pain, and disability interfering with their quality of life. Moreover, psychiatric disorders interfere with rheumatologic diagnosis, which relates to signs of a diseased mind as being an indication of an underlying rheumatologic condition. This has often made it difficult to disentangle between isolated primary rheumatologic conditions and musculoskeletal manifestations due to psychiatric disorders.</span></p> <p></div></div> <div style="background: #f7f7f7;border: 1px solid rgba(0, 0, 0, 0.07);"> <div style="padding: 30px;"><div class="Adblock-main"> <div class="Adblock-head"> <h2>Yearwise Publication Trend on <b>“<a href="https://nursing-science.com/publication-trends/index/rheumatology" target="_blank" title="rheumatology - yearwise publication trends">rheumatology</a>”</b></h2> </div> </div><div class="results-container"><div class="chart-block" style="padding:15px;"> <div class="left"> <div id="results" class="results"></div> </div> <div class="right"> <div class="chart-container"><canvas id="publicationChart"></canvas></div> </div> <div class="keywordsdiv"> <div style="text-align:center;"><b>Find publication trends on relevant topics</b> </div> <span class="gp-icon icon-tags"><svg viewBox="0 0 512 512" aria-hidden="true" xmlns="http://www.w3.org/2000/svg" width="1em" height="1em"><path d="M20 39.5c-8.836 0-16 7.163-16 16v176c0 4.243 1.686 8.313 4.687 11.314l224 224c6.248 6.248 16.378 6.248 22.626 0l176-176c6.244-6.244 6.25-16.364.013-22.615l-223.5-224A15.999 15.999 0 00196.5 39.5H20zm56 96c0-13.255 10.745-24 24-24s24 10.745 24 24-10.745 24-24 24-24-10.745-24-24z"></path><path d="M259.515 43.015c4.686-4.687 12.284-4.687 16.97 0l228 228c4.686 4.686 4.686 12.284 0 16.97l-180 180c-4.686 4.687-12.284 4.687-16.97 0-4.686-4.686-4.686-12.284 0-16.97L479.029 279.5 259.515 59.985c-4.686-4.686-4.686-12.284 0-16.97z"></path></svg></span> <span id="keyword-stats"></span> </div> </div></div></div><div class="inside-article"><style> table { margin: 0 0 1.5em; 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In their clinical practice, rheumatologists can come across situations when it is challenging to establish whether the symptoms that the patient complains of are predominantly of rheumatic origin or are substantially colored by psychiatric disease. Consequently, GP decision-making may become protracted, costly, and potentially misleading, and a spectrum of diagnostic uncertainty appears or diagnostic confusion or diagnostic imprecision seems to occur.</span></p> <p><span style="font-weight: 400;">Furthermore, there is always the predisposing factor of different psychiatric disorders that may affect the outcome of the treatment. For example, patients with comorbid depression and/or anxiety may show lesser treatment compliance, worse coping behaviors, and a higher probability of continuing self-report of symptomatology even when on appropriate treatments. These factors can often interfere with the management of rheumatologic conditions and can cause persistent or aggravated symptoms, which in turn add to the patient’s psychological issues.</span></p> <h3><b>The Demand for Standardized Psychiatric Examination</b></h3> <p><b></b><span style="font-weight: 400;">Due to this, it is clear that among rheumatology patients, a large proportion suffer from psychiatric disorders and should therefore be screened for these conditions. Mental health screening in rheumatology clinics may identify patients who will require early intervention, thus increasing patient prognosis. PRIME-MD has been used effectively to detect psychiatric disorders in primary care settings, and its use in rheumatologic practice can be easily envisaged.</span></p> <p><span style="font-weight: 400;">It will also ensure that rheumatologists and mental health caregivers are regularly in touch, and hence the patients have a better chance of being managed holistically. He or she can diagnose and treat a patient’s mental health disorder early enough, thus enabling the rheumatologist to possibly come up with relevant treatment plans that would leave those suffering from rheumatic diseases with relatively low levels of both physical and psychological dysfunction.</span></p> <h3><b>Barriers to Implementation</b></h3> <p><b></b><span style="font-weight: 400;">That is why there are several barriers to the implementation of mental health screening in rheumatology, as follows: The most difficult of these is the small amount of time one is likely to spend with the patient during consultations. The major areas of concern in rheumatology clinics involve the evaluation of multiple aspects of complicated musculoskeletal complaints, which often afford restricted opportunities for performing comprehensive psychiatric assessments. Also, the rheumatologists’ may not be well-trained and may not be fully confident in identifying and treating psychiatric disorders, and therefore they may not incorporate adequate mental health screening.</span></p> <p><span style="font-weight: 400;">One of them is cultural; decisions based on culture still frown at people with such disorders, thus discouraging the patient from revealing signs of a malfunctioning mind or seeking help. A sub-theme is the feeling of rejection that patients have for seeking help from a different doctor for mental problems; a worry that their physical symptoms will be regarded as fabricated or overstated if they come out and admit to having mental problems. These kinds of stigma can be a major barrier to the adoption of mental health screening as part of the usual rheumatologic practice.</span></p> <p></div></div> <div style="background: #f7f7f7;border: 1px solid rgba(0, 0, 0, 0.07);"> <div style="padding: 30px;"><div class="Adblock-main"> <div class="Adblock-head"> <h2>Recent Publications on <b>“<a href="https://nursing-science.com/recent-publications/index/rheumatology" target="_blank" rel="noopener" title="rheumatology - yearwise publication list">rheumatology</a>”</b></h2> </div> </div> <div class="pb-main"><div class="article-scroll"><div id="results_recent" class="results"></div></div><div class="keywordsdiv" style="margin: 0px 15px;margin-top:20px;"> <div style="text-align:center;"><b>Find publications on relevant topics</b> </div> <span class="gp-icon icon-tags"><svg viewBox="0 0 512 512" aria-hidden="true" xmlns="http://www.w3.org/2000/svg" width="1em" height="1em"><path d="M20 39.5c-8.836 0-16 7.163-16 16v176c0 4.243 1.686 8.313 4.687 11.314l224 224c6.248 6.248 16.378 6.248 22.626 0l176-176c6.244-6.244 6.25-16.364.013-22.615l-223.5-224A15.999 15.999 0 00196.5 39.5H20zm56 96c0-13.255 10.745-24 24-24s24 10.745 24 24-10.745 24-24 24-24-10.745-24-24z"></path><path d="M259.515 43.015c4.686-4.687 12.284-4.687 16.97 0l228 228c4.686 4.686 4.686 12.284 0 16.97l-180 180c-4.686 4.687-12.284 4.687-16.97 0-4.686-4.686-4.686-12.284 0-16.97L479.029 279.5 259.515 59.985c-4.686-4.686-4.686-12.284 0-16.97z"></path></svg></span> <span id="keyword-papers"></span> </div></div></div><div class="inside-article"> <style> .pb-main{ border: solid 1px #ccc; border-top: none; margin-bottom: 20px; padding-bottom: 25px; background:#fff; } .author-main { border: solid 1px #ccc; border-top: none; margin-bottom: 20px; padding-bottom: 25px; background:#fff; } .publication-block { padding: 10px; margin-bottom: 10px; background-color: #f9f9f9; text-align: left; background: #FFF; border-bottom: solid 1px #ccc; margin-left: 15px; margin-right: 15px; } .publication-block h3 { margin: 0 0 10px; color: #000!important; } .publication-block a { font-size: 16px !important; line-height: 1em; font-weight: 600; text-transform: none; color: #000; padding: 0px; } .publication-block a:hover{ color: #227cdc; text-decoration:underline; } .article-scroll { max-height: 445px; overflow-y: auto; overflow-x: hidden; } ::-webkit-scrollbar-track { -webkit-box-shadow: inset 0 0 6px rgba(0,0,0,0.3); background-color: #efefef; border-radius:30px; } ::-webkit-scrollbar { width: 6px; background-color: #efefef; border-radius:30px; } ::-webkit-scrollbar-thumb { background-color: #ababab; border-radius:30px; } .publication-block p { margin-bottom: .5em; font-size: 15px; color: #000; } h3 { font-size: 18px !important; margin-bottom: 20px; line-height: 1.2em; font-weight: 600; text-transform: none; } a { padding: 5px; color: #a71c49; } #keyword-papers{ margin-top: 20px; text-align: center; } </style> <script> function decodeString(str) { str = str.replace(/\\'/g, "'"); str = str.replace(/\\'/g, "'"); str = str.replace(/\\'/g, "'"); return str; } function displayResults_recent(papers) { var resultsContainer = document.getElementById('results_recent'); if (!papers || papers.length === 0) { resultsContainer.innerHTML = '<p>No recent publications found.</p>'; return; } papers.forEach(paper => { var publicationBlock = document.createElement('div'); publicationBlock.className = 'publication-block'; var title_de = decodeString(paper.title); var publicationHTML = ` <div style="margin-bottom: 10px;line-height: 24px;"><a href="${paper.url}" target="_blank" title="${title_de}">${title_de}</a></div> <p><strong>Issue Release:</strong> ${paper.publishedDate}</p> `; publicationBlock.innerHTML = publicationHTML; resultsContainer.appendChild(publicationBlock); }); } function displayKeywordPapers(keywords) { var resultsContainer = document.getElementById('keyword-papers'); resultsContainer.innerHTML = ''; if (!keywords || keywords.length === 0) { resultsContainer.innerHTML = '<p>No data found.</p>'; return; } var keywordHTML = ''; keywords.forEach((key, index) => { let key_replace = key.replace(/ /g, '-'); key_replace = key_replace.toLowerCase(); keywordHTML += `<a href="https://nursing-science.com/recent-publications/index/${key_replace}" target="_blank" title="${key} - publication list">${key}</a>`; if (index < keywords.length - 1) { keywordHTML += ', '; } }); resultsContainer.innerHTML = keywordHTML; } // Call the function with the PHP data var recent_papers = [ { "title": "The Hydroxychloroquine Conundrum: Striking the Right Balance Between Safety and Efficacy in Rheumatology Practice.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38923852", "publishedDate": "2024" }, { "title": "Evaluating patient-reported adherence and outcomes in specialty disease states: A dual-site initiative.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38950163", "publishedDate": "2024" }, { "title": "Canadian Rheumatology Association\/Spondyloarthritis Research Consortium of Canada Living Treatment Recommendations for the Management of Axial Spondyloarthritis.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38950949", "publishedDate": "2024" }, { "title": "Canadian Rheumatology Association Annual Scientific Meeting; RBC Convention Centre (and Virtually); Winnipeg, Manitoba, Canada; February 28-March 2, 2024.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38950967", "publishedDate": "2024" }, { "title": "Pediatric rheumatology education: the virtual frontier a review.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38840147", "publishedDate": "2024" }, { "title": "Association of sustained lupus low disease activity state with improved outcomes in systemic lupus erythematosus: a multinational prospective cohort study.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38876129", "publishedDate": "2024" }, { "title": "Social media has become a mainstream source of medical information for patients with rheumatic diseases: a cross-sectional survey of patients.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38850324", "publishedDate": "2024" }, { "title": "Adaptation of the comprehensive rheumatologic assessment of frailty (CRAF) as a multidimensional frailty screening tool in patients with rheumatoid arthritis in Vietnam.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38849947", "publishedDate": "2024" }, { "title": "EULAR recommendations for the involvement of patient research partners in rheumatology research: 2023 update.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38876509", "publishedDate": "2024" }, { "title": "II Brazilian Society of Rheumatology consensus for lupus nephritis diagnosis and treatment.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38890752", "publishedDate": "2024" }, { "title": "The spectrum of giant cell arteritis through a rheumatology lens.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38898105", "publishedDate": "2024" }, { "title": "Late-age onset systemic sclerosis-clinical and serological characteristics.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38904748", "publishedDate": "2024" }, { "title": "Editorial overview: Special issue on \\\\\\\"Rheumatology: Therapeutic advances for autoimmune and musculoskeletal diseases\\\\\\\".", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38763082", "publishedDate": "2024" }, { "title": "A proposal for using benefit-risk methods to improve the prominence of adverse event results when reporting trials.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38909232", "publishedDate": "2024" }, { "title": "A pilot study of childhood-onset Takayasu arteritis using whole exome sequencing suggests oligogenic inheritance involving classical complement, collagen, and autoinflammatory pathways.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38869681", "publishedDate": "2024" }, { "title": "Sexual dysfunction and self-perceived sexual health in patients with rheumatoid arthritis and systemic lupus erythematosus: results from a cross-sectional survey.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38914773", "publishedDate": "2024" }, { "title": "Managing rheumatoid arthritis and cardiovascular disease: the role of physical medicine and rehabilitation.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38914772", "publishedDate": "2024" }, { "title": "Expert opinion on the management of patients with osteoporosis with anabolic drugs in Italy.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38916162", "publishedDate": "2024" }, { "title": "Nipocalimab, an anti-FcRn monoclonal antibody, in participants with moderate to severe active rheumatoid arthritis and inadequate response or intolerance to anti-TNF therapy: results from the phase 2a IRIS-RA study.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38942592", "publishedDate": "2024" }, { "title": "Highlights of Interdisciplinary Care in Rheumatology.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38942586", "publishedDate": "2024" } ]; var keywordsArray = ["Rheumatology","Mental Health Screening","Psychiatric Disorders","Musculoskeletal Complaints","Integrated Care","Depression","Anxiety","PRIME-MD"]; displayResults_recent(recent_papers); displayKeywordPapers(keywordsArray); // function stripslashes(str) { // if (typeof str === 'string') { // return str.replace(/\/g, ''); // } // } </script></p> <h3><b>Strategies for Overcoming Barriers</b></h3> <p><b></b><span style="font-weight: 400;">To eradicate such barriers, the following can be employed: Several strategies can be put into practice. Firstly, rheumatology practices can incorporate standardized brief mental health questionnaires that have been shown to take little time to complete and score and can often be done within the time available usually utilized for an average consultation. For a depression assessment, the Patient Health Questionnaire (PHQ-9) is one of the brief instruments that can be used even in a busy clinical setting; another is the Generalized Anxiety Disorder 7-item (GAD-7) scale for testing for anxiety.</span></p> <p><span style="font-weight: 400;">Secondly, rheumatology training programs should include knowledge about diagnosing and managing psychiatric disorders, which should prepare rheumatologists to act competently and confidently in managing mentally ill patients. CME programs can also be used to provide practicing rheumatologists with new information on mental health screens and treatment.</span></p> <p><span style="font-weight: 400;">In third place, it is recommended to encourage synergy between rheumatologists and mental health practitioners for better client outcomes. Creating referral linkage systems and care coordination plans in which mental health professionals are easily reachable within rheumatology clinics can help in the early identification and management of psychiatric disorders among patients.</span></p> <h3><b>The Role of Integrated Care</b></h3> <p><span style="font-weight: 400;">Treatment programs that are a combined delivery of mental health services and rheumatology have been reported to produce better results. In such models, mental health specialists collaborate with rheumatologists in the integrated management of patients who seek to treat the physical as well as psychological well-being of the patients. Besides increasing the efficiency of recognizing and addressing patients with psychiatric disorders, it also provides a better understanding and handling of rheumatological diseases.</span></p> <p><span style="font-weight: 400;">The analysis of the literature review showed that integrated care provides patient satisfaction and treatment compliance, as well as the prevention of the worsening status of physical and mental health conditions. Engaging with the issues related to the delineation of mental health within rheumatology, integrated care models are beneficial for offering a considerably longer and more reframed approach to healthcare, thus corresponding to the patient’s needs better in the long run.</span></p> <h3><b>Conclusion</b></h3> <p><span style="font-weight: 400;">Mental health screening in rheumatology is a well-established, significant, yet underappreciated aspect of the evaluation and management of rheumatology patients. The prevalence of psychiatric disorders in patients with rheumatology was significantly high, and this warranted screening for such disorders so that patients gain the correct diagnosis, treatment, and better prognosis. Despite such challenges, they can be hardly an insurmountable obstacle if and when brief screening tools are used, rheumatologists are trained adequately, and mental health support is provided within rheumatology practice.</span></p> <p><span style="font-weight: 400;">This not only represents a huge missed opportunity to address the obvious mental health concerns of these patients, but it also undercuts rheumatology practices’ ability to provide comprehensive, patient-centered care that is so desperately needed to improve the quality of life of these patients and, indeed, their overall health. It has become high time for rheumatology to embrace the concept of mental health and musculoskeletal health and ensure patients get the attention they deserve.</span></p> <p></p> <h3><b>References</b></h3> <ol> <li>O’Malley, P.G., Jackson, J.L., Kroenke, K., Yoon, I.K., Hornstein, E. and Dennis, G.J., 1998. <a href="https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/210516">The value of screening for psychiatric disorders in rheumatology referrals.</a> <i>Archives of Internal Medicine</i>, <i>158</i>(21), pp.2357-2362.</li> <li>Parker, T., May, P.A., Maviglia, M.A., Petrakis, S., Sunde, S. and Gloyd, S.V., 1997. <a href="https://journals.sagepub.com/doi/abs/10.2190/C6FD-7QWB-KNGR-M844">PRIME-MD: its utility in detecting mental disorders in American Indians.</a> <i>The International Journal of Psychiatry in Medicine</i>, <i>27</i>(2), pp.107-128.</li> <li>Valenstein, M., Kales, H., Mellow, A., Dalack, G., Figueroa, S., Barry, K.L. and Blow, F.C., 1998. <a href="https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415.1998.tb01533.x">Psychiatric diagnosis and intervention in older and younger patients in a primary care clinic: effect of a screening and diagnostic instrument.</a> <i>Journal of the American Geriatrics Society</i>, <i>46</i>(12), pp.1499-1505.</li> <li>Katon, W., Von Korff, M., Lin, E., Walker, E., Simon, G.E., Bush, T., Robinson, P. and Russo, J., 1995. <a href="https://jamanetwork.com/journals/jama/article-abstract/387748">Collaborative management to achieve treatment guidelines: impact on depression in primary care.</a> <i>Jama</i>, <i>273</i>(13), pp.1026-1031.</li> <li>Nease, D.E., Volk, R.J. and Cass, A.R., 1999. <a href="https://www.jabfm.org/content/12/1/21.short">Investigation of a severity-based classification of mood and anxiety symptoms in primary care patients.</a> <i>The Journal of the American Board of Family Practice</i>, <i>12</i>(1), pp.21-31.</li> <li>Kobak, K.A., Dottl, S.L., Greist, J.H., Jefferson, J.W., Burroughs, D., Mantle, J.M., Katzelnick, D.J., Norton, R., Henk, H.J. and Serlin, R.C., 1997. <a href="https://jamanetwork.com/journals/jama/article-abstract/418187">A computer-administered telephone interview to identify mental disorders.</a> <i>Jama</i>, <i>278</i>(11), pp.905-910.</li> <li>Ormel, J., VonKorff, M., Ustun, T.B., Pini, S., Korten, A. and Oldehinkel, T., 1994. <a href="https://jamanetwork.com/journals/jama/article-abstract/383978">Common mental disorders and disability across cultures: results from the WHO Collaborative Study on Psychological Problems in General Health Care.</a> <i>Jama</i>, <i>272</i>(22), pp.1741-1748.</li> </ol> <p></div></div> <div style="background: #f7f7f7;border: 1px solid rgba(0, 0, 0, 0.07);"> <div style="padding: 30px;"><div class="Adblock-main"> <div class="Adblock-head"> <h2>Top Experts on “<b style="color:#000;font-size:22px;">rheumatology</b>“</h2> </div> </div><div class="author-main"><div id="results_author"></div><div style="text-align: center;"><a class="register-button" href="https://nursing-science.com/expert-search" target="_blank" rel="noopener">Find experts on any field</a></div></div><div class="inside-article" style="background: none;border: none;box-shadow: none;margin-top: -70px;"> <style> .author-block { padding: 15px; 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Calabrese", "citation_count": 38620, "hindex": 78, "paper_count": 408, "affiliation": "Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland OH, United States; Center for Vasculitis Care and Research, Cleveland Clinic, Cleveland, OH, United States. ", "email": "calabrl@ccf.org", "slug_tail": "l-calabrese" }, "opjSK4wBWBy50K-rLOYL": { "aid": "opjSK4wBWBy50K-rLOYL", "name": "C. Crowson", "citation_count": 23129, "hindex": 78, "paper_count": 449, "affiliation": "From the Division of Rheumatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA. ", "email": "crowson@mayo.edu", "slug_tail": "c-crowson" } }; //console.log(authors_data); displayResults_author(authors_data); var keywordsArray = ["Rheumatology","Mental Health Screening","Psychiatric Disorders","Musculoskeletal Complaints","Integrated Care","Depression","Anxiety","PRIME-MD"]; displayKeywordAuthors(keywordsArray); </script></p> </div> <footer class="entry-meta" aria-label="Entry meta"> <span class="cat-links"><span class="gp-icon icon-categories"><svg viewBox="0 0 512 512" aria-hidden="true" xmlns="http://www.w3.org/2000/svg" width="1em" height="1em"><path d="M0 112c0-26.51 21.49-48 48-48h110.014a48 48 0 0143.592 27.907l12.349 26.791A16 16 0 00228.486 128H464c26.51 0 48 21.49 48 48v224c0 26.51-21.49 48-48 48H48c-26.51 0-48-21.49-48-48V112z" /></svg></span><span class="screen-reader-text">Categories </span><a href="https://nursing-science.com/archive/category/rheumatology/" rel="category tag">Rheumatology</a></span> <span class="tags-links"><span class="gp-icon 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