Ludovic Bacconnier1, Nathalie Rincheval1, René-Marc Flipo1, Philippe Goupille1, Jean-Pierre Daures1, Jean-Philippe Boulenger1, Bernard Combe2. 1. Lapeyronie Hospital, Montpellier I University, UMR 5535, EA2415, Montpellier, France, Lille University Hospital, Lille 2 University, Lille, Tours University Hospital, UMR CNRS 7292, University of Tours, Tours and La Colombiere Hospital, CHRU Montpellier I University, Montpellier, France. 2. Lapeyronie Hospital, Montpellier I University, UMR 5535, EA2415, Montpellier, France, Lille University Hospital, Lille 2 University, Lille, Tours University Hospital, UMR CNRS 7292, University of Tours, Tours and La Colombiere Hospital, CHRU Montpellier I University, Montpellier, France. b-combe@chu-montpellier.
Abstract
OBJECTIVE: RA is a chronic disease with frequent psychological co-morbidities, of which depression and anxiety are two common manifestations. We aimed to identify predictive factors of psychological distress in a large prospective cohort of very early RA patients. METHODS: ESPOIR (Etude et Suivi des Polyarthrites Indifférenciées Récentes) is a multicentre, longitudinal and prospective cohort study of patients with early arthritis (<6 months disease duration). The study sample comprised 641 patients with very early RA according to the 2010 ACR/European League Against Rheumatism RA criteria from the ESPOIR cohort. Psychological distress was assessed over 3 years by the five-item Mental Health Inventory questionnaire at various time points (baseline, 6, 12, 18, 24 and 36 months). Logistic regression with a generalized estimating equation model was used to analyse the association of disease variables and risk of psychological distress. RESULTS: At baseline, 46.9% of RA patients were screened as positive for psychological distress. Over 3 years, psychological distress decreased significantly, with a prevalence of 25.8% at 36 months. The HAQ Disability Index (HAQ-DI) score was the most important factor predicting psychological distress over 3 years [odds ratio 2.10 (95% CI 1.41, 3.14)-3.59 (2.29, 5.63)]. Baseline biological and radiological variables and treatment regimens were not associated with distress. CONCLUSION: Psychological distress in very early RA is frequent and the HAQ-DI score is a predictor of depression and anxiety in these patients. A psychological evaluation in patients with early RA is important for further individual psychiatric diagnosis and management.
OBJECTIVE:RA is a chronic disease with frequent psychological co-morbidities, of which depression and anxiety are two common manifestations. We aimed to identify predictive factors of psychological distress in a large prospective cohort of very early RApatients. METHODS: ESPOIR (Etude et Suivi des Polyarthrites Indifférenciées Récentes) is a multicentre, longitudinal and prospective cohort study of patients with early arthritis (<6 months disease duration). The study sample comprised 641 patients with very early RA according to the 2010 ACR/European League Against Rheumatism RA criteria from the ESPOIR cohort. Psychological distress was assessed over 3 years by the five-item Mental Health Inventory questionnaire at various time points (baseline, 6, 12, 18, 24 and 36 months). Logistic regression with a generalized estimating equation model was used to analyse the association of disease variables and risk of psychological distress. RESULTS: At baseline, 46.9% of RApatients were screened as positive for psychological distress. Over 3 years, psychological distress decreased significantly, with a prevalence of 25.8% at 36 months. The HAQ Disability Index (HAQ-DI) score was the most important factor predicting psychological distress over 3 years [odds ratio 2.10 (95% CI 1.41, 3.14)-3.59 (2.29, 5.63)]. Baseline biological and radiological variables and treatment regimens were not associated with distress. CONCLUSION: Psychological distress in very early RA is frequent and the HAQ-DI score is a predictor of depression and anxiety in these patients. A psychological evaluation in patients with early RA is important for further individual psychiatric diagnosis and management.
Authors: Aleid C Boer; Robin M Ten Brinck; Andrea W M Evers; Annette H M van der Helm-van Mil Journal: Arthritis Res Ther Date: 2018-05-03 Impact factor: 5.156