AB0314 QUALITY OF LIFE IN WOMEN WITH RHEUMATOID ARTHRITIS DEPENDING ON ANXIETY AND DEPRESSION

Abstract

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes joint damage, deformity, and pain. This can lead to loss of functionality and mobility, which entails a decrease in the quality of life and the possible occurrence of anxiety and depressive disorders[1]. Objectives: Assess the quality of life in women with RA, depending on the severity of anxiety and depression. Methods: The study included 104 women with reliable RA according to the ACR1987 and/or EULAR/ACR2010 criteria (mean age 53,7 ± 10,9 years, mean duration of RA - 10,1 [4;14] years, DAS28 - 4,96 [4,27;5,77]). An assessment of the severity of anxiety and depression was conducted using a questionnaire for the hospital scale of depression and anxiety (HADS). Evaluation of the quality of life of patients with rheumatoid arthritis was performed using the EQ-5D index. Depending on the degree of functional impairment, according to the HAQ questionnaire, were regarded as minimal (0,5-1 point), moderate (1-2) and pronounced (2-3 points), the population norm was 0-0,5 points. The severity of pain was determined by VAS: no pain (0-4 mm), mild pain (5-44 mm), moderate pain (45-74 mm), severe pain (75-100 mm). Statistical processing was performed using the program STATISTICA 10.0. Results: The frequency of occurrence of anxiety-depressive disorders in patients with RA was determined: clinically significant anxiety was detected in 20 (19.2%) patients, depression - in 19 (17,3%); subclinical anxiety - in 26 (25%), depression - in 27 (25,9%) patients; the absence of reliably expressed symptoms of anxiety in 58 (55,8%) patients, depression - in 59 (56,8%) patients. HAQ functional impairment was absent in 11 (10,6%) patients, minimal impairment was detected in 20 (19,2%), moderate - in 52 (50%), and pronounced in 21 (20,2%) patients. Severe pain in the VAS was noted by 38 (36.6%) patients, moderate - 51 (49%), in 15 (14.4%) patients the pain syndrome was weakly expressed. The HAQ and EQ-5D indices for women were 1,26 [0,88;1,75] and 0.41 [0,07;0,59], respectively. The relationships between the HAQ and EQ-5D indices (r = 0,67, p <0,05), the HAQ index and the age of the patients (r = 0,33, p <0,05), and the duration of the disease (r = 0,29, p <0,05), ESR indicator (r = 0,28, p <0,05), CRP (r = 0,37, p <0,05), the level of pain in VAS (r = 0,4, p <0,05), DAS28 index (r = 0,32, p <0,05), anxiety severity (r = 0,22, p <0,05), depression severity (r = 0,31, p < 0,05). The relationship between the EQ-5D index and the age of the patients (r = 0,29, p <0,05), with the duration of the disease (r = 0,22, p <0,05), CRP (r = 0,32, p <0,05), the level of pain in VAS (r = 0,45, p <0,05), the severity of anxiety (r = 0,28, p <0,05), the severity of depression (r = 0,35, p <0,05). To clarify the relationship between the quality of life of patients and the level of depression and anxiety, two groups were identified: no anxietydepressive disorders (N = 43) and the second group with their presence (N = 30). The EQ-5D index in the first group was 0,59 [0,52; 0,62] and in the group with anxiety and depressive disorders it was 0,27 [-0,02; 0,52] (p = 0,005). The HAQ index significantly differed in women without anxiety and depressive disorders 1,0 [0,625; 1,5] with the index in the other group 1,75 [1,0; 2,125] (p = 0,01). Conclusion: Thus, every fifth patient with RA suffers from clinically significant anxiety and depression; subclinical anxiety and depression were found in 26% of patients with RA. Interrelations between the indicators of quality of life of patients with RA and the patient's age, duration, activity of RA, severity of anxiety and depressive disorders.