Thank you for your thoughtful and detailed feedback regarding our study, “Research Trends of Rheumatoid Arthritis and Depression from 2019 to 2023: A Bibliometric Analysis” published in the Journal of Multidisciplinary Healthcare.1 We appreciate your recognition of the contributions our research makes toward understanding the relationship between rheumatoid arthritis (RA) and depression, as well as the need for further exploration in this area.

In our bibliometric study, we observed that research on the relationship between RA and depression in China exhibits comparatively limited international collaboration relative to other countries.2 I hypothesize that this may be due to the methodologies used in psychiatry research, which often require the use of scales, psychological interviews, and other techniques. Language and cultural background play crucial roles in this context, as differences in these areas can lead to significant heterogeneity in research outcomes. USA, UK, and Canada share English as their official language and have similar cultural backgrounds, facilitating greater international collaboration among them. In contrast, China’s unique language and cultural context may hinder its participation in international partnerships. However, striving for diversified international collaboration remains a goal for the future.

Additionally, the authors note that many studies conducted are cross-sectional, which may not provide a deep understanding of the causal relationship between RA and depression. We strongly agree with this perspective, particularly in the field of psychiatry, where longitudinal studies are essential. Only through a substantial number of longitudinal studies can we uncover potential mechanisms rather than merely observing superficial correlations. Zheng et al suggest through a cross-sectional analysis that the brain dynamics of Depersonalization-Derealization Disorder (DPD) could serve as a potential biomarker for diagnosis and symptom assessment.3 They validated this hypothesis by comparing analyses conducted before and after transcranial Direct Current Stimulation (tDCS) intervention, thereby providing a paradigm for longitudinal studies in psychiatry. This approach extends beyond mere correlation, offering a degree of validation for causal relationships. We will certainly consider integrating similar methodologies in our future research to enhance our findings and their applicability to clinical practice.

As we move forward, we are dedicated to refining our bibliometric analysis approach to include a broader range of studies and methodologies, which will contribute to a more comprehensive understanding of the complexities involved in the relationship between RA and depression.

Thank you once again for your valuable insights. We look forward to further dialogue and collaboration in the future to advance our shared interest in this critical area of research.

The authors report no conflicts of interest in this communication.

1. Zhao Y, Chen GY, Fang M. Research trends of rheumatoid arthritis and depression from 2019 to 2023: a bibliometric analysis. J Multidiscip Healthc. 2024;17:4465–4474. doi:10.2147/JMDH.S478748

2. Agussalim YE, Nugroho HSW, Nugroho HS. Response to research trends of rheumatoid arthritis and depression. J Multidiscip Healthc. 2024;17:4743–4744. doi:10.2147/JMDH.S497920

3. Zheng S, Zhang FX, Shum HPH, et al. Unraveling the brain dynamics of depersonalization-derealization disorder: a dynamic functional network connectivity analysis. BMC Psychiatry. 2024;24(1):685. doi:10.1186/s12888-024-06096-1