抑郁症：类风湿关节炎女性的常见共病——来自奥地利横断面研究的结果。
Depression: a common comorbidity in women with rheumatoid arthritis-results from an Austrian cross-sectional study.
机构信息
Rheumatology private practice, Stockerau, Austria
Private practice, Wels, Upperaustria, Austria.
出版信息
BMJ Open. 2020 Feb 2;10(1):e033958. doi: 10.1136/bmjopen-2019-033958.
OBJECTIVES
Previous research showed that depression is common in rheumatoid arthritis (RA). However, the prevalence very much depends on different assessment tools and sociocultural differences, respectively. The main study aim and research question was to investigate the proportion of depressive symptoms in Austrian female patients with RA.
SETTING
A nationwide multicentre study with seven secondary care centres all over Austria (hospital-based rheumatological outpatient clinics and private practices).
PARTICIPANTS
319 patients with RA and 306 healthy controls (HCO), all female Caucasians, were asked to complete a Beck's Depression Inventory-Fast Screen (BDI-FS). Patients and HCO were ≥18 years. Patients had to fulfil the 2010 classification criteria for RA. In addition, disease activity, disability, medication, drinking of alcoholic beverages, smoking and occupational status were evaluated.
PRIMARY AND SECONDARY OUTCOME MEASURES
A BDI-FS cut-off value of ≥4, per definition, indicates the presence of a depressive symptomatology.
RESULTS
The return rate of questionnaires was high: 235/319 (73.7%) in patients with RA and 180/306 (58.8%), ending up with 392 complete questionnaires from 223 patients with RA (69.9%) and 169 HCO (55.2%). The BDI-FS was significantly higher in patients with RA (median BDI-FS 2 (IQR 0-4) vs median 1 (IQR 0-2) in HCO, p<0.001). BDI-FS scores from ≥4, which by definition indicate depression, were found in 29.6% of patients with RA and 12.4% of HCO (p<0.001). Depressive symptoms were strongly associated with disease activity (Clinical Disease Activity Index, p<0.001) and disability (Health Assessment Questionnaire, p<0.005). No association of depressive symptoms with age, alcohol consumption, smoking, occupational status or use of medication was found.
CONCLUSIONS
One-third of female patients with RA showed depressive symptoms. Depression was significantly higher in female patients with RA than in female HCO and was strongly associated with disease activity and disability. It would be of interest to address the same question in male participants.
目的
先前的研究表明，抑郁症在类风湿关节炎（RA）中很常见。然而，患病率在很大程度上取决于不同的评估工具和社会文化差异。主要研究目的和研究问题是调查奥地利女性 RA 患者出现抑郁症状的比例。
背景
一项全国性多中心研究，涉及奥地利的七个二级保健中心（医院风湿病门诊和私人诊所）。
参与者
319 名 RA 患者和 306 名健康对照者（HCO），均为女性白种人，被要求完成贝克抑郁量表快速筛查（BDI-FS）。患者和 HCO 的年龄均≥18 岁。患者必须符合 2010 年 RA 分类标准。此外，评估了疾病活动度、残疾、药物治疗、饮酒、吸烟和职业状况。
主要和次要结局测量
BDI-FS 分界值≥4 按定义表示存在抑郁症状。
结果
问卷调查的回复率很高：RA 患者为 235/319（73.7%），HCO 为 180/306（58.8%），最终有 223 名 RA 患者（69.9%）和 169 名 HCO（55.2%）完成了 392 份完整的问卷。RA 患者的 BDI-FS 明显更高（中位数 BDI-FS 2（IQR 0-4）vs HCO 中位数 1（IQR 0-2），p<0.001）。BDI-FS 得分≥4，按定义表示抑郁，在 RA 患者中为 29.6%，HCO 中为 12.4%（p<0.001）。抑郁症状与疾病活动度（临床疾病活动指数，p<0.001）和残疾（健康评估问卷，p<0.005）密切相关。未发现抑郁症状与年龄、饮酒、吸烟、职业状况或药物使用有关。
结论
三分之一的女性 RA 患者出现抑郁症状。女性 RA 患者的抑郁程度明显高于女性 HCO，且与疾病活动度和残疾密切相关。在男性参与者中探讨同样的问题将很有趣。
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