Učestalost depresije/anksioznosti i njena povezanost sa kvalitetom života kod bolesnika sa reumatoidnim artritisom
Keywords:
anksioznost;, artritis, reumatoidni;, depresija;, prevalenca;, prognoza;, kvalitet života;, ankete i upitnici.
Abstract
Uvod/Cilj. Reumatoidni artritis (RA) praćen je mnogobrojnim komorbiditetima među kojima depresija i anksioznost (D/A) zauzimaju značajno mesto. Cilj rada bio je da se proceni učestalost D/A kod bolesnika sa RA i njena povezanost sa kvalitetom života (KŽ). Metode. Ispitivanjem su obuhvaćeni bolesnici sa RA, lečeni na Klinici za reumatologiju Vojnomedicinske akademije u Beogradu, Srbija, u periodu od maja do novembra 2016. godine. Aktivnost bolesti je procenjivana pomoću Disease Activity Score 28-SE (DAS28-SE). Pomoću Hospital Anxiety and Depression Scale (HADS) i petog pitanja European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L) upitnika određivani su D/A. Za procenu KŽ korišćena su tri upitnika: opšti RAND 36-item Health Survey 1.0 (RAND36), specifični upitnik KŽ osoba obolelih od RA (RAQoL) i upitnik EQ-5D-3L. Rezultati. Na osnovu HADS upitnika, učestalost depresije iznosila je 52%, sa prosečnom vrednošću HADS skora 7,6 ± 3,2, dok je učestalost anksioznosti iznosila 32%, sa srednjom vrednošću HADS skora 5,8 ± 3,8. Pomoću petog pitanja EQ-5D upitnika nađena je učestalost D/A od 77,4%, od čega je umerenu D/A imalo 71,7%, a izraženu 5,7% bolesnika. Kod ispitivanih bolesnika je pomoću sva tri upitnika utvrđena narušenost u svim domenima KŽ. Upitnikom RAQoL pokazana je umerena narušenost KŽ, sa vrednošću skora 15,5 ± 7,9. Vrednost EQ-VAS skora iznosila je 58,6 ± 16,0, dok je EQ-5D indeks iznosio 0,6 ± 0,3. Univarijantnom linearnom regresijom dobijena je statistički značajna negativna prediktivna vrednost KŽ za prisustvo D/A. Multivarijantnom linearnom regresijom pokazana je statistički značajna nezavisna negativna prediktivna vrednost KŽ, procenjena pomoću RAQoL upitnika (p = 0,010) i mentalne komponente KŽ RAND 36 upitnika (p = 0,030) za stepen depresije. Zaključak. Kod bolesnika sa RA postoji značajna učestalost D/A kao i narušenost KŽ u svim domenima. Sprovedenim ispitivanjima je pokazano da KŽ ima statistički značajnu negativnu prediktivnu vrednost za prisustvo D/A.
References
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8. Zigmond AP, Snaith RP. the hospital and depression scale. Acta psychiat 1983;67:361-70
9. Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med 2001; 33: 337-43).
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12. P.P. Katz, E.H. Yelin Prevalence and correlates of depressive symptoms among persons with rheumatoid arthritis J Rheumatol, 20 (1993), pp. 790–796
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14. Arne M, Janson C, Janson S, Boman G, Lindqvist U, Berne C, Emtner M Physical activity and quality of life in subjects with chronic disease: Chronic obstructive pulmonary disease compared with rheumatoid arthritis and diabetes mellitus
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17. Yokogawa at all. Identifying anxiety and depression among rheumatoid arthritis patients using the multidimensional helath assessment questionnaire. Abstract number: 2628
18. Y.M. El-Miedany, A.H. El-Rasheed Is anxiety amore common disorder than depression in rheumatoid arthritis? Joint Bone Spine, 69 (2002), pp. 300–306
19. Uguz F, Akman C, Kucuksarac S, Tufekci O: Anti tumor necrosis factor therapy is associated with less frequent mood and anxiety disorders in patients with rheumatoid arthritis. Psychiatry Clin Neurosci 2009, 63:50-55.
20. Salaffi F, Carotti M, Gasparini S, Intorcia M, Grassi W. The health-related quaity of life in rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis: a comparison with a selected sample of health people. Health Qual Life Outcomes 2009; 10;7-25
21. Evers AW, Kraaimaat FW, Geenen R, Jacobs JW, Bijlsma JW. Longterm predictors of anxiety and depressed mood in early rheumatoid arthritis; a 3 and 5 years followup. J Rheumatol 2002; 29(11): 2327-36).
22. Katz PP, Yelin EH. Activity loss and the onset of depressive symptoms: do some activities matter more than others? Arthritis Rheum. 2001;44(5):1194–1202.
23. E. West, S.W. Jonsson Health-related quality of life in rheumatoid arthritis in Northern Sweden: a comparison between patients with early RA, patients with medium-term disease and controls, using SF-36 Clin Rheumatol, 24 (2005), pp. 117–122
24. P. Minnock, O. Fitzgerald, B. BresnihanWomen with established rheumatoid arthritis perceive pain as the predominant impairment of health status Br J Rheumatol, 42 (2003), pp. 995–1000).
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26. Katon W, Lin EH, Kroenke K. The association of depression and anxiety with medical symptom burden in patients with chronic medical illness. General Hospital Psychiatry. 2007;29(2):147-155.
27. Rayner L, Matcham F, Hutton J, Stringer C, Dobson J, Steer S, et al. Embedding integrated mental health assessment and management in general hospital settings: feasibility, acceptability and the prevalence of common mental disorder. Gen Hosp Psychiatry. 2014;36:318–24.)
28. National Collaborating Centre for Mental Health. Depression in adults with a chronic physical health problem: Treatment and management. United Kingdom. London: National Institute for Health and Clinical Excellence; 2009. Clinical Guidance 91
REFERENCES
1. Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA) Dougados M, et al. Ann Rheum Dis 2014;73:62–68
2. Rayner L, Matcham F, Hutton J, Stringer C, Dobson J, Steer S, et al.Embedding integrated mental health assessment and management in general hospital settings: feasibility, acceptability and the prevalence of common mental disorder. Gen Hosp Psychiatry. 2014;36:318–24.
3. Lok EYC, Mok CC, Cheng CW et al. Prevalence and determinants of psychiatric disorders in patients with rheumatoid arthritis. Psychosomatics 2010;51:33838.e8.
4. Isik A, Koca SS, Ozturk A et al. Anxiety and depression in patients with rheumatoid arthritis. Clin Rheumatol 2007; 26:8728.
5. Uguz F, Akman C, Kucuksarac S, Tufekci O: Anti tumor necrosis factor therapy is associated with less frequent mood and anxiety disorders in patients with rheumatoid arthritis. Psychiatry Clin Neurosci 2009, 63:50-55.
6. Wolfe F, Michaud K: Predicting depression in rheumatoid arthritis: The signal importance of pain extent and fatigue, and comorbidity. Arthritis Care Res 2009, 61:667-673..
7. Lin EH, Katon W, Von Korff M, et al. (2003) Effect of improving depression care on pain and functional outcomes among older adults with arthritis: A randomized controlled trial. Journal of the American Medical Association 290(18): 2428–2429).
8. Zigmond AP, Snaith RP. the hospital and depression scale. Acta psychiat 1983;67:361-70
9. Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med 2001; 33: 337-43).
10. Hays RD, Sherbourne CD, Mazel RM. The RAND 36‐item Health Survey 1.0. Health Econ 1993;2:217–27.
11. Lillegraven S, Kvien TK. Measuring disability and quality of life in established rheumatoid arthritis. Best Pract Res Clin rheumatol 2007;21:827-40
12. P.P. Katz, E.H. Yelin Prevalence and correlates of depressive symptoms among persons with rheumatoid arthritis J Rheumatol, 20 (1993), pp. 790–796
13. H. Mostafa, A. Radwan The relationship between disease activity and depression in Egyptian patients with rheumatoid arthritis Egypt Rheumatol, 35 (4) (2013), pp. 193–199).
14. Arne M, Janson C, Janson S, Boman G, Lindqvist U, Berne C, Emtner M Physical activity and quality of life in subjects with chronic disease: Chronic obstructive pulmonary disease compared with rheumatoid arthritis and diabetes mellitus
15. Rathbun A, Harrold r, Reed G. A description of patient and rheumatologist-reported depression symptoms in an American rheumatoid arthritis registry population. Clin Exp rheumatol. 2014, 32:523-32.
16. Hider S, Tanveer W, Brownfield A, Mattey D, Packham J. Depression in RA patients treated with anti-TNF is common and under-recognized in the rheumatology clinic. Rheumatology.2009;48:1152-4.
17. Yokogawa at all. Identifying anxiety and depression among rheumatoid arthritis patients using the multidimensional helath assessment questionnaire. Abstract number: 2628
18. Y.M. El-Miedany, A.H. El-Rasheed Is anxiety amore common disorder than depression in rheumatoid arthritis? Joint Bone Spine, 69 (2002), pp. 300–306
19. Uguz F, Akman C, Kucuksarac S, Tufekci O: Anti tumor necrosis factor therapy is associated with less frequent mood and anxiety disorders in patients with rheumatoid arthritis. Psychiatry Clin Neurosci 2009, 63:50-55.
20. Salaffi F, Carotti M, Gasparini S, Intorcia M, Grassi W. The health-related quaity of life in rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis: a comparison with a selected sample of health people. Health Qual Life Outcomes 2009; 10;7-25
21. Evers AW, Kraaimaat FW, Geenen R, Jacobs JW, Bijlsma JW. Longterm predictors of anxiety and depressed mood in early rheumatoid arthritis; a 3 and 5 years followup. J Rheumatol 2002; 29(11): 2327-36).
22. Katz PP, Yelin EH. Activity loss and the onset of depressive symptoms: do some activities matter more than others? Arthritis Rheum. 2001;44(5):1194–1202.
23. E. West, S.W. Jonsson Health-related quality of life in rheumatoid arthritis in Northern Sweden: a comparison between patients with early RA, patients with medium-term disease and controls, using SF-36 Clin Rheumatol, 24 (2005), pp. 117–122
24. P. Minnock, O. Fitzgerald, B. BresnihanWomen with established rheumatoid arthritis perceive pain as the predominant impairment of health status Br J Rheumatol, 42 (2003), pp. 995–1000).
25. T. Covic, B. Adamson, D. Spencer, G. Howe A biopsy chosocial model of pain and depression in rheumatoid arthritis: a12-month longitudinal study Rheumatology, 42 (2003), pp. 1287–1294
26. Katon W, Lin EH, Kroenke K. The association of depression and anxiety with medical symptom burden in patients with chronic medical illness. General Hospital Psychiatry. 2007;29(2):147-155.
27. Rayner L, Matcham F, Hutton J, Stringer C, Dobson J, Steer S, et al. Embedding integrated mental health assessment and management in general hospital settings: feasibility, acceptability and the prevalence of common mental disorder. Gen Hosp Psychiatry. 2014;36:318–24.)
28. National Collaborating Centre for Mental Health. Depression in adults with a chronic physical health problem: Treatment and management. United Kingdom. London: National Institute for Health and Clinical Excellence; 2009. Clinical Guidance 91
1. Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA) Dougados M, et al. Ann Rheum Dis 2014;73:62–68
2. Rayner L, Matcham F, Hutton J, Stringer C, Dobson J, Steer S, et al.Embedding integrated mental health assessment and management in general hospital settings: feasibility, acceptability and the prevalence of common mental disorder. Gen Hosp Psychiatry. 2014;36:318–24.
3. Lok EYC, Mok CC, Cheng CW et al. Prevalence and determinants of psychiatric disorders in patients with rheumatoid arthritis. Psychosomatics 2010;51:33838.e8.
4. Isik A, Koca SS, Ozturk A et al. Anxiety and depression in patients with rheumatoid arthritis. Clin Rheumatol 2007; 26:8728.
5. Uguz F, Akman C, Kucuksarac S, Tufekci O: Anti tumor necrosis factor therapy is associated with less frequent mood and anxiety disorders in patients with rheumatoid arthritis. Psychiatry Clin Neurosci 2009, 63:50-55.
6. Wolfe F, Michaud K: Predicting depression in rheumatoid arthritis: The signal importance of pain extent and fatigue, and comorbidity. Arthritis Care Res 2009, 61:667-673..
7. Lin EH, Katon W, Von Korff M, et al. (2003) Effect of improving depression care on pain and functional outcomes among older adults with arthritis: A randomized controlled trial. Journal of the American Medical Association 290(18): 2428–2429).
8. Zigmond AP, Snaith RP. the hospital and depression scale. Acta psychiat 1983;67:361-70
9. Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med 2001; 33: 337-43).
10. Hays RD, Sherbourne CD, Mazel RM. The RAND 36‐item Health Survey 1.0. Health Econ 1993;2:217–27.
11. Lillegraven S, Kvien TK. Measuring disability and quality of life in established rheumatoid arthritis. Best Pract Res Clin rheumatol 2007;21:827-40
12. P.P. Katz, E.H. Yelin Prevalence and correlates of depressive symptoms among persons with rheumatoid arthritis J Rheumatol, 20 (1993), pp. 790–796
13. H. Mostafa, A. Radwan The relationship between disease activity and depression in Egyptian patients with rheumatoid arthritis Egypt Rheumatol, 35 (4) (2013), pp. 193–199).
14. Arne M, Janson C, Janson S, Boman G, Lindqvist U, Berne C, Emtner M Physical activity and quality of life in subjects with chronic disease: Chronic obstructive pulmonary disease compared with rheumatoid arthritis and diabetes mellitus
15. Rathbun A, Harrold r, Reed G. A description of patient and rheumatologist-reported depression symptoms in an American rheumatoid arthritis registry population. Clin Exp rheumatol. 2014, 32:523-32.
16. Hider S, Tanveer W, Brownfield A, Mattey D, Packham J. Depression in RA patients treated with anti-TNF is common and under-recognized in the rheumatology clinic. Rheumatology.2009;48:1152-4.
17. Yokogawa at all. Identifying anxiety and depression among rheumatoid arthritis patients using the multidimensional helath assessment questionnaire. Abstract number: 2628
18. Y.M. El-Miedany, A.H. El-Rasheed Is anxiety amore common disorder than depression in rheumatoid arthritis? Joint Bone Spine, 69 (2002), pp. 300–306
19. Uguz F, Akman C, Kucuksarac S, Tufekci O: Anti tumor necrosis factor therapy is associated with less frequent mood and anxiety disorders in patients with rheumatoid arthritis. Psychiatry Clin Neurosci 2009, 63:50-55.
20. Salaffi F, Carotti M, Gasparini S, Intorcia M, Grassi W. The health-related quaity of life in rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis: a comparison with a selected sample of health people. Health Qual Life Outcomes 2009; 10;7-25
21. Evers AW, Kraaimaat FW, Geenen R, Jacobs JW, Bijlsma JW. Longterm predictors of anxiety and depressed mood in early rheumatoid arthritis; a 3 and 5 years followup. J Rheumatol 2002; 29(11): 2327-36).
22. Katz PP, Yelin EH. Activity loss and the onset of depressive symptoms: do some activities matter more than others? Arthritis Rheum. 2001;44(5):1194–1202.
23. E. West, S.W. Jonsson Health-related quality of life in rheumatoid arthritis in Northern Sweden: a comparison between patients with early RA, patients with medium-term disease and controls, using SF-36 Clin Rheumatol, 24 (2005), pp. 117–122
24. P. Minnock, O. Fitzgerald, B. BresnihanWomen with established rheumatoid arthritis perceive pain as the predominant impairment of health status Br J Rheumatol, 42 (2003), pp. 995–1000).
25. T. Covic, B. Adamson, D. Spencer, G. Howe A biopsy chosocial model of pain and depression in rheumatoid arthritis: a12-month longitudinal study Rheumatology, 42 (2003), pp. 1287–1294
26. Katon W, Lin EH, Kroenke K. The association of depression and anxiety with medical symptom burden in patients with chronic medical illness. General Hospital Psychiatry. 2007;29(2):147-155.
27. Rayner L, Matcham F, Hutton J, Stringer C, Dobson J, Steer S, et al. Embedding integrated mental health assessment and management in general hospital settings: feasibility, acceptability and the prevalence of common mental disorder. Gen Hosp Psychiatry. 2014;36:318–24.)
28. National Collaborating Centre for Mental Health. Depression in adults with a chronic physical health problem: Treatment and management. United Kingdom. London: National Institute for Health and Clinical Excellence; 2009. Clinical Guidance 91
REFERENCES
1. Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA) Dougados M, et al. Ann Rheum Dis 2014;73:62–68
2. Rayner L, Matcham F, Hutton J, Stringer C, Dobson J, Steer S, et al.Embedding integrated mental health assessment and management in general hospital settings: feasibility, acceptability and the prevalence of common mental disorder. Gen Hosp Psychiatry. 2014;36:318–24.
3. Lok EYC, Mok CC, Cheng CW et al. Prevalence and determinants of psychiatric disorders in patients with rheumatoid arthritis. Psychosomatics 2010;51:33838.e8.
4. Isik A, Koca SS, Ozturk A et al. Anxiety and depression in patients with rheumatoid arthritis. Clin Rheumatol 2007; 26:8728.
5. Uguz F, Akman C, Kucuksarac S, Tufekci O: Anti tumor necrosis factor therapy is associated with less frequent mood and anxiety disorders in patients with rheumatoid arthritis. Psychiatry Clin Neurosci 2009, 63:50-55.
6. Wolfe F, Michaud K: Predicting depression in rheumatoid arthritis: The signal importance of pain extent and fatigue, and comorbidity. Arthritis Care Res 2009, 61:667-673..
7. Lin EH, Katon W, Von Korff M, et al. (2003) Effect of improving depression care on pain and functional outcomes among older adults with arthritis: A randomized controlled trial. Journal of the American Medical Association 290(18): 2428–2429).
8. Zigmond AP, Snaith RP. the hospital and depression scale. Acta psychiat 1983;67:361-70
9. Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med 2001; 33: 337-43).
10. Hays RD, Sherbourne CD, Mazel RM. The RAND 36‐item Health Survey 1.0. Health Econ 1993;2:217–27.
11. Lillegraven S, Kvien TK. Measuring disability and quality of life in established rheumatoid arthritis. Best Pract Res Clin rheumatol 2007;21:827-40
12. P.P. Katz, E.H. Yelin Prevalence and correlates of depressive symptoms among persons with rheumatoid arthritis J Rheumatol, 20 (1993), pp. 790–796
13. H. Mostafa, A. Radwan The relationship between disease activity and depression in Egyptian patients with rheumatoid arthritis Egypt Rheumatol, 35 (4) (2013), pp. 193–199).
14. Arne M, Janson C, Janson S, Boman G, Lindqvist U, Berne C, Emtner M Physical activity and quality of life in subjects with chronic disease: Chronic obstructive pulmonary disease compared with rheumatoid arthritis and diabetes mellitus
15. Rathbun A, Harrold r, Reed G. A description of patient and rheumatologist-reported depression symptoms in an American rheumatoid arthritis registry population. Clin Exp rheumatol. 2014, 32:523-32.
16. Hider S, Tanveer W, Brownfield A, Mattey D, Packham J. Depression in RA patients treated with anti-TNF is common and under-recognized in the rheumatology clinic. Rheumatology.2009;48:1152-4.
17. Yokogawa at all. Identifying anxiety and depression among rheumatoid arthritis patients using the multidimensional helath assessment questionnaire. Abstract number: 2628
18. Y.M. El-Miedany, A.H. El-Rasheed Is anxiety amore common disorder than depression in rheumatoid arthritis? Joint Bone Spine, 69 (2002), pp. 300–306
19. Uguz F, Akman C, Kucuksarac S, Tufekci O: Anti tumor necrosis factor therapy is associated with less frequent mood and anxiety disorders in patients with rheumatoid arthritis. Psychiatry Clin Neurosci 2009, 63:50-55.
20. Salaffi F, Carotti M, Gasparini S, Intorcia M, Grassi W. The health-related quaity of life in rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis: a comparison with a selected sample of health people. Health Qual Life Outcomes 2009; 10;7-25
21. Evers AW, Kraaimaat FW, Geenen R, Jacobs JW, Bijlsma JW. Longterm predictors of anxiety and depressed mood in early rheumatoid arthritis; a 3 and 5 years followup. J Rheumatol 2002; 29(11): 2327-36).
22. Katz PP, Yelin EH. Activity loss and the onset of depressive symptoms: do some activities matter more than others? Arthritis Rheum. 2001;44(5):1194–1202.
23. E. West, S.W. Jonsson Health-related quality of life in rheumatoid arthritis in Northern Sweden: a comparison between patients with early RA, patients with medium-term disease and controls, using SF-36 Clin Rheumatol, 24 (2005), pp. 117–122
24. P. Minnock, O. Fitzgerald, B. BresnihanWomen with established rheumatoid arthritis perceive pain as the predominant impairment of health status Br J Rheumatol, 42 (2003), pp. 995–1000).
25. T. Covic, B. Adamson, D. Spencer, G. Howe A biopsy chosocial model of pain and depression in rheumatoid arthritis: a12-month longitudinal study Rheumatology, 42 (2003), pp. 1287–1294
26. Katon W, Lin EH, Kroenke K. The association of depression and anxiety with medical symptom burden in patients with chronic medical illness. General Hospital Psychiatry. 2007;29(2):147-155.
27. Rayner L, Matcham F, Hutton J, Stringer C, Dobson J, Steer S, et al. Embedding integrated mental health assessment and management in general hospital settings: feasibility, acceptability and the prevalence of common mental disorder. Gen Hosp Psychiatry. 2014;36:318–24.)
28. National Collaborating Centre for Mental Health. Depression in adults with a chronic physical health problem: Treatment and management. United Kingdom. London: National Institute for Health and Clinical Excellence; 2009. Clinical Guidance 91
Published
2022/12/02
Section
Original Paper