Covic Tanya, Tyson Graham, Spencer David, Howe Graydon
School of Psychology, University of Western Sydney, Penrith South DC, Sydney, NSW 1797, Australia.
J Psychosom Res. 2006 May;60(5):469-76. doi: 10.1016/j.jpsychores.2005.09.011.
To confirm the prevalence of depression in a sample of rheumatoid arthritis (RA) patients; to identify the most significant predictors of depression in RA and to explore patients attitudes to medication in relation to depression.
A cross-sectional survey was used to collect data from 134 RA patients (77% female, 23% male). Participants were divided into depressed and nondepressed groups based on their scores on the Center for Epidemiological Studies-Depression (CES-D) scale. Discriminant analysis was conducted to identify the predictors that would best categorise patients into those two groups.
Twelve predictors correctly classified 80% of patients into depressed or nondepressed groups. The strongest predictors of depression were high tension and low self-esteem followed by the perceived impact of RA, fatigue, passive coping, pain, and physical disability. Other predictors included medication effectiveness and importance as well as perceived lack of control over pain.
Both physical and psychological factors have an impact on depression in RA. The key predictors identified in this study need to be considered within the regular RA management as possible cues to depression development.
确定类风湿关节炎（RA）患者样本中抑郁症的患病率；确定类风湿关节炎患者抑郁症最显著的预测因素，并探讨患者对与抑郁症相关药物治疗的态度。
采用横断面调查从134例类风湿关节炎患者（77%为女性，23%为男性）中收集数据。根据参与者在流行病学研究中心抑郁量表（CES-D）上的得分分为抑郁组和非抑郁组。进行判别分析以确定能将患者最佳地分为这两组的预测因素。
12个预测因素将80%的患者正确分类为抑郁或非抑郁组。抑郁症最强的预测因素是高度紧张和低自尊，其次是类风湿关节炎的感知影响、疲劳、消极应对、疼痛和身体残疾。其他预测因素包括药物疗效和重要性以及对疼痛缺乏控制感。
生理和心理因素均对类风湿关节炎患者的抑郁症有影响。本研究中确定的关键预测因素在类风湿关节炎的常规管理中需要作为抑郁症发展的可能线索加以考虑。
