Psychological affection in rheumatoid arthritis patients in relation to disease activity

Abstract

Rheumatoid arthritis (RA) is a common, systemic autoimmune disease characterized by persistent symmetric polyarthritis (synovitis). Anxiety and depression are common among patients with RA, compared to the general population and have been associated with increased pain, fatigue, physical disability and health care costs, and an overall reduced health-related quality of life. The aim of the present study was to assess the relation between psychological factors (anxiety and depression) and disease activity (and severity) parameters in RA patients. This national, single-center, cross-sectional study recruited over 6 months 25 patients with RA diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria, and 25 healthy control individuals. All participants were subjected to the clinical and laboratory evaluation of disease activity and psychological assessment according to the International Classification of Mental and Behavioral Disorders tenth revision. Significance and regression analyses were performed to determine disease activity and severity predictors. 80% of RA patients had depression and 52% anxiety symptoms, while only 8% of healthy controls reported mild depression (P < .001). Data also found highly significant correlation between depressive symptoms and RA disease activity (P < .05). Psychiatric manifestations are common in RA and they strongly correlate with severity of the disease. Abbreviations: ACR = American College of Rheumatology, CRP = C reactive protein, DAS28 = disease activity score in 28 joints, ESR = erythrocyte sedimentation rate, HAQ-DI = health assessment questionnaire disability index, ICD-10 = the International Classification of Mental and Behavioral Disorders tenth revision, RA = rheumatoid arthritis, RF = rheumatoid factor, SD = standard deviation, VAS = visual analog scale.