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抑郁和焦虑对类风湿关节炎、膝骨关节炎及纤维肌痛综合征患者生活质量的影响。

Effects of depression and anxiety on quality of life of patients with rheumatoid arthritis, knee osteoarthritis and fibromyalgia syndrome.

作者信息

Ozcetin A, Ataoglu S, Kocer E, Yazici S, Yildiz O, Ataoglul A, Icmeli C

机构信息

Department of Psychiatry, Duzce Faculty of Medicine, Abant Izzet Baysal University Duzce, Turkey.

出版信息

West Indian Med J. 2007 Mar;56(2):122-9. doi: 10.1590/s0043-31442007000200004.

Abstract

OBJECTIVE

To measure the effects of depression and anxiety on quality of life (QoL) in patients with rheumatoid arthritis (RA), knee osteoarthritis (OA) and fibromyalgia syndrome (FMS).

METHODS

One hundred and fifty-four patients with RA, knee OA, and FMS who presented to the physical medicine and rehabilitation department were studied. For evaluation of the patients, Beck depression scale, Beck anxiety scale, and Short Form-36 were used.

RESULTS

Twenty-two per cent of patients (n = 34) were diagnosed with of RA, 52.6% (n = 81) knee OA and 25.3% (n = 39) FMS. Except for the subscales, of physical and emotional role, there were statistically significant differences among diagnostic groups in the rest of the SF-36 subscales. In the physical functioning subscale, the highest score was obtained in the fibromyalgia group and the lowest in the RA group (p < 0.001). However, in the bodily pain subscale, the lowest score was recorded in the fibromyalgia group (p = 0.019). In all diagnostic groups, the scores of SF-36 subscales were significantly low in patients who scored above the threshold value of Beck depression scale (p < 0. 001). A strong negative correlation was detected between scores of Beck anxiety scale and the scores of all SF36 subscales in patients with RA and knee OA. On the other hand, in patients with FMS, anxiety scores correlated negatively with only physical and somatic function scores of SF-36.

CONCLUSION

Quality of life is significantly low in patients with RA, knee OA and FMS, whose depression and/or anxiety scores are high. Therefore, these patients should be managed using a multidisciplinary approach including psychiatric support.

摘要

目的

测量抑郁和焦虑对类风湿关节炎(RA)、膝骨关节炎(OA)和纤维肌痛综合征(FMS)患者生活质量(QoL)的影响。

方法

对154例到物理医学与康复科就诊的RA、膝OA和FMS患者进行研究。采用贝克抑郁量表、贝克焦虑量表和简明健康状况调查量表(SF-36)对患者进行评估。

结果

22%(n = 34)的患者被诊断为RA,52.6%(n = 81)为膝OA,25.3%(n = 39)为FMS。除了生理职能和情感职能分量表外,SF-36其余分量表在各诊断组之间存在统计学显著差异。在生理功能分量表中,纤维肌痛组得分最高,RA组得分最低(p < 0.001)。然而,在躯体疼痛分量表中,纤维肌痛组得分最低(p = 0.019)。在所有诊断组中,贝克抑郁量表得分高于阈值的患者,其SF-36分量表得分显著较低(p < 0.001)。在RA和膝OA患者中,贝克焦虑量表得分与所有SF-36分量表得分之间存在强烈的负相关。另一方面,在FMS患者中,焦虑得分仅与SF-36的生理和躯体功能得分呈负相关。

结论

RA、膝OA和FMS患者中,抑郁和/或焦虑得分较高者的生活质量显著较低。因此,应对这些患者采用包括精神支持在内的多学科方法进行管理。

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