Although depression is known to be an important complication in patients with rheumatoid arthritis (RA) or Sjogrens syndrome (SS), at present little is known about the mental states of RA patients who also have SS. To address that issue, we recently used a standardized questionnaire, the self-rating depression scale (SDS), to compare the mental states of patients with RA alone and those with RA complicated by SS. There were no significant differences between the two groups with respect to age, sex, arthralgia, patient global assessment or dosage of steroid. On the other hand, the SDS scores of RA patients with SS were significantly higher than those of RA patients without SS. Among the twenty items on the SDS questionnaire, RA patients with SS complained of “constipation” significantly more often than RA patients without SS. Collectively, our findings suggest SS exacerbates depression in RA patients. In discussing our findings, we describe the features of the depression seen in patients with RA, SS and RA with secondary SS, and make comparisons among these three groups.