Hill Catherine L, Gill Tiffany, Taylor Anne W, Daly Alison, Grande Eleonora Dal, Adams Robert J
Rheumatology Unit, The Queen Elizabeth Hospital, 28 Woodville Rd, Woodville, South Australia 5011, Australia.
Clin Rheumatol. 2007 Jul;26(7):1049-54. doi: 10.1007/s10067-006-0439-3. Epub 2006 Oct 18.
Previous studies using clinic or convenience samples have indicated that not only patients with arthritis are at increased risk of depression, but there may also be a link between depression and disability in people with arthritis. We examined the prevalence of psychological distress in a population sample with and without arthritis and the association with health-related quality of life. The WANTS Health and Well-being Survey was a population household telephone interview survey of adults (age > or =18 years) in three states of Australia. Data obtained were weighted to provide population-representative estimates. The survey included questions regarding arthritis, SF-12, the Kessler 10 index of psychological distress and presence of mental health conditions. A total of 7,473 interviews providing information on arthritis were completed, with 1,364 (18.3%) reporting arthritis. Self-reported mental health conditions were more frequent in those with arthritis (14.9 vs 12.0%, p = 0.004), and a higher proportion were at a medium or high risk for anxiety or depression (39.0 vs 31.0%, p < 0.001). People with arthritis had significantly lower scores on the SF-12 physical component summaries compared to those without arthritis. Among those with arthritis, those with coexisting psychological distress had significantly lower scores on the SF-12 physical component summary than those without psychological distress. Psychological distress is common among people with arthritis in the community. In arthritis, psychological distress makes a significant additional negative impact on the physical well-being. Physicians need to recognize and address this additional impact on physical functioning in patients with arthritis.
以往使用临床样本或便利样本的研究表明，不仅关节炎患者患抑郁症的风险增加，而且抑郁症与关节炎患者的残疾之间可能也存在联系。我们调查了患有关节炎和未患关节炎的人群样本中心理困扰的患病率及其与健康相关生活质量的关联。“澳大利亚全国健康与幸福调查”是一项针对澳大利亚三个州成年人（年龄≥18岁）的全国家庭电话访谈调查。所获数据经过加权处理以提供具有人口代表性的估计值。该调查包括有关关节炎、SF-12健康调查简表、凯斯勒心理困扰10项指标以及心理健康状况的问题。总共完成了7473份提供有关关节炎信息的访谈问卷，其中1364人（18.3%）报告患有关节炎。患有关节炎者自我报告的心理健康状况更为常见（14.9%对12.0%，p = 0.004），并且焦虑或抑郁处于中度或高度风险的比例更高（39.0%对31.0%，p < 0.001）。与未患关节炎者相比，患有关节炎者的SF-12身体状况总结得分显著更低。在患有关节炎者中，同时存在心理困扰者的SF-12身体状况总结得分显著低于无心理困扰者。心理困扰在社区中的关节炎患者中很常见。在关节炎患者中，心理困扰会对身体健康产生显著的额外负面影响。医生需要认识到并应对这种对关节炎患者身体功能的额外影响。
