The prevalence of depression/anxiety among patients with rheumatoid arthritis and its relationship with quality of life
Ključne reči:
anxiety;, arthritis, rheumatoid;, depression;, prevalence;, prognosis;, quality of life;, surveys and questionnaires.
Sažetak
Background/Aim. Rheumatoid arthritis (RA) is accompanied by numerous comorbidities, among which depression and anxiety (D/A) occupy a significant place. The aim of the study was to determine the prevalence of D/A in RA patients and the relationship with their quality of life (QoL). Methods. The study included RA patients treated at the Rheumatology Clinic of the Military Medical Academy in Belgrade, Serbia in the period from May to November 2016. Disease activity was assessed by the Disease Activity Score 28-SE (DAS28-SE). D/A was determined using the Hospital Anxiety and Depression Scale (HADS) questionnaire and European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L) questionnaire Question 5. Three questio-nnaires were used to assess QoL: the general RAND 36-item Health Survey 1.0 (RAND36), the specific Rheumatoid Arthritis Quality of Life Questionnaire (RAQoL) and EQ-5D-3L. Results. Based on the HADS questionnaire, the prevalence of depression was 52% with the average HADS score value of 7.6 ± 3.2, while the prevalence of anxiety was 32% with the mean HADS score value of 5.8 ± 3.8. Question 5 of the EQ-5D questionnaire showed that the prevalence of D/A was 77.4%, of which 71.7% of patients had moderate D/A, while 5.7% of patients had severe D/A. Impairment in all the domains of QoL was found in tested patients, as assessed by all three questionnaires. The RAQoL questionnaire showed moderate QoL impairment, with a score value of 15.5 ± 7.9. The EQ-VAS score value was 58.6 ± 16.0, while the EQ-5D index was 0.6 ± 0.3. Univariate linear regression produced a statistically significant negative predictive value of QoL for the presence of D/A. Multivariate linear regression showed a statistically significant independent negative predictive value of QoL, as assessed by the RAQoL questionnaire (p = 0.010) and the mental QoL component of the RAND 36 questionnaire (p = 0.030) for the degree of depression. Conclusion. In RA patients, there is a significant prevalence of D/A as well as impairment of QoL in all domains. The tests performed have shown that QoL has a statistically significant negative predictive value for the presence of D/A.
Reference
REFERENCES
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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
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
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2022/12/02
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