الفهرس 
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Abstract
Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune disease and the most common form of chronic joint inflammation and is most prevalent in individuals aged 40 years or older with the risk of developing RA being up to 5 times higher in women. As a consequence of their disease, RA patients typically suffer severe joint pain, reduced muscle strength, and impaired physical function (Lemmey et al., 2009)
Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that may affect multiple organ systems, including the central nervous system (CNS) (Benedict et al., 2008).
Anxiety and depression are higher in patients with chronic medical diseases than general population (15-23% versus 6.6%) (Isik et al., 2007).
As RA in a chronic disease, anxiety and depression are common among patients with RA with the prevalence being higher than that of the general population (28–44% versus 6.6%) (Kessler et al., 2003, Ang et al., 2005 , Zyrianova et al., 2006 and Isik et al., 2007) and has been associated with increased pain, fatigue, reduced health-related quality of life , increased levels of physical disability and increased disease activity (Ang et al., 2005).
Depression presented in 11%–39% of patients may be the initial symptom before the diagnosis of SLE (Marian et al., 2010 ) .It was reported that there were 4 times higher prevalence of depression in SLE compared to a matched, non-SLE population. In addition, anxiety is quite common in SLE patients, often as a reaction to the illness. Ainiala et al 2001 have reported that the anxiety disorders were twice as prevalent among SLE patients as compared to the controls. Whether depression and anxiety are associated with lupus activity remains debatable.
In this study, our main target is to assess the prevalence of depression and anxiety in RA and SLE patients and the relation between anxiety and depression with disease activity parameters in both Rheumatoid arthritis and systemic lupus erythromatosus patients.
Seventy five patients were included in this study. They were divided into three groups which include 25 RA patients, 25 SLE patients and 25 healthy controls.
All patients were subjected to full history taking, clinical examination, laboratory investigations, depression and anxiety diagnosis by The ICD-10 (International Classification of Mental and Behavioral Disorders) Clinical descriptions and diagnostic guidelines World Health Organization and assessment of disease activity in both RA using DAS28 score and SLE using SLEDAI.
Our study found that in RA group there is 20 patient (80%) having depression and 13 (52%) having anxiety symptoms while in SLE group 13 (52%) are having depression and 12 (48%) are having anxiety symptoms there is also high significant difference between both groups and healthy controls.