C C Mok1, E Y C Lok, E F C Cheung. 1. Department of Medicine, Tuen Mun Hospital, Hong Kong, China. ccmok2005@yahoo.com
Abstract
OBJECTIVES: To study the effect of concurrent psychiatric disorders on health-related quality of life (HRQOL) in patients with rheumatoid arthritis (RA). METHODS: Consecutive Chinese patients who fulfilled the American College of Rheumatology (ACR) criteria for RA were recruited and interviewed by a psychiatrist for psychiatric disorders using the Chinese Bilingual Structured Clinical Interview for DSM-IV Axis I Disorders, Patient version (CB-SCID-I/P). HRQOL was assessed by the validated Chinese version of the 36-item Short Form Health Survey (SF-36). Sociodemographic and clinical data were also collected. Fatigue was assessed by the Functional Assessment of Chronic Illness Therapy - Fatigue scale (FACIT-F). RESULTS: Two hundred patients with RA were studied (79% women, mean age 51.4 ± 10.5 years; median RA duration 4.0 years). Forty-seven (23.5%) patients were diagnosed with a psychiatric disorder: depressive disorders in 29 patients and anxiety disorders in 26 patients. Patients with either condition had significantly higher fatigue scores (26 ± 8.8 vs. 16 ± 6.9, p < 0.001) and were more likely to be unemployed (p = 0.02) and dependent on government subsidy for living (p < 0.001) than those without. The scores of the eight domains and the physical and mental components of the SF-36 were significantly lower in RA patients with psychiatric disorders (p < 0.001 in all). In a linear regression model, the presence of either depressive or anxiety disorders (β = -0.23, p < 0.001), older age (β = -0.16, p = 0.006), self-perceived pain (β = -0.25, p < 0.001) and fatigue (β = -0.42, p < 0.001) were independently and inversely associated with the total SF-36 score after adjustment for disease activity and other sociodemographic variables. CONCLUSIONS: Concomitant depressive or anxiety disorders in RA patients are associated with significantly poorer HRQOL. Early identification and treatment of psychiatric disorders in RA patients are warranted.
OBJECTIVES: To study the effect of concurrent psychiatric disorders on health-related quality of life (HRQOL) in patients with rheumatoid arthritis (RA). METHODS: Consecutive Chinese patients who fulfilled the American College of Rheumatology (ACR) criteria for RA were recruited and interviewed by a psychiatrist for psychiatric disorders using the Chinese Bilingual Structured Clinical Interview for DSM-IV Axis I Disorders, Patient version (CB-SCID-I/P). HRQOL was assessed by the validated Chinese version of the 36-item Short Form Health Survey (SF-36). Sociodemographic and clinical data were also collected. Fatigue was assessed by the Functional Assessment of Chronic Illness Therapy - Fatigue scale (FACIT-F). RESULTS: Two hundred patients with RA were studied (79% women, mean age 51.4 ± 10.5 years; median RA duration 4.0 years). Forty-seven (23.5%) patients were diagnosed with a psychiatric disorder: depressive disorders in 29 patients and anxiety disorders in 26 patients. Patients with either condition had significantly higher fatigue scores (26 ± 8.8 vs. 16 ± 6.9, p < 0.001) and were more likely to be unemployed (p = 0.02) and dependent on government subsidy for living (p < 0.001) than those without. The scores of the eight domains and the physical and mental components of the SF-36 were significantly lower in RApatients with psychiatric disorders (p < 0.001 in all). In a linear regression model, the presence of either depressive or anxiety disorders (β = -0.23, p < 0.001), older age (β = -0.16, p = 0.006), self-perceived pain (β = -0.25, p < 0.001) and fatigue (β = -0.42, p < 0.001) were independently and inversely associated with the total SF-36 score after adjustment for disease activity and other sociodemographic variables. CONCLUSIONS: Concomitant depressive or anxiety disorders in RApatients are associated with significantly poorer HRQOL. Early identification and treatment of psychiatric disorders in RApatients are warranted.
Authors: Kirsten M Fiest; Carol A Hitchon; Charles N Bernstein; Christine A Peschken; John R Walker; Lesley A Graff; Ryan Zarychanski; Ahmed Abou-Setta; Scott B Patten; Jitender Sareen; James Bolton; Ruth Ann Marrie Journal: J Clin Rheumatol Date: 2017-12 Impact factor: 3.517
Authors: R A Marrie; R Walld; J M Bolton; J Sareen; J R Walker; S B Patten; A Singer; L M Lix; C A Hitchon; R El-Gabalawy; A Katz; J D Fisk; C N Bernstein Journal: Epidemiol Psychiatr Sci Date: 2017-11-03 Impact factor: 6.892