Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
Department of Psychiatry, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
Clin Rheumatol. 2020 Dec;39(12):3723-3732. doi: 10.1007/s10067-020-05094-4. Epub 2020 May 23.
Adult-onset Still's disease (AOSD) is an autoinflammatory disorder leading to multiorgan involvements. We sought to investigate mood status and the health-related quality of life (HRQoL) in these patients.
In this study, 82 AOSD patients and 82 age- and sex-matched healthy controls were included. Demographic and clinical data of recruited patients were collected. The Hospital Anxiety and Depression Scale (HADS) and Medical Outcomes Survey Short Form-36 (SF-36) were used to evaluate the mood status and quality of life, respectively. Spearman correlation and multivariable linear regression analyses were used to assess the disease-related risk factors associated with anxiety and depression.
Forty-four active and thirty-eight relieved patients were enrolled. We found that scores of both HADS anxiety (HADS-A) and depression (HADS-D) subscales in active AOSD were significantly higher than inactive patients, which were significantly higher than controls. Moreover, the HADS-A was positively correlated to the patient's global assessment (PGA), pain, and dosage of prednisone, and the HADS-D was positively correlated to systemic score, PGA, and pain. Female, high dosage of corticosteroids, and PGA more than 50 had a significant association with HADS-A score, while the sore throat and PGA more than 50 had a significant association with HADS-D score. Furthermore, AOSD patients' anxiety and depression had a negative impact on HRQoL.
Active AOSD patients tended to be anxious and depressed, suffering from poorer HRQoL compared to patients in remission. Therefore, the evaluation of mental health and HRQoL should be included in AOSD patients' long-term management. Key Points • Adult-onset Still's disease (AOSD) is a systemic inflammatory disorder leading to multiorgan involvement. This study was so far the first published research focuses on AOSD patients' mental involvement and health-related quality of life (HRQoL). • Active AOSD patients were more tended to be anxious and depressive and suffered from poorer HRQoL compared to inactive patients. • Patients' anxiety and depression were associated with impaired HRQoL.
成人斯蒂尔病（AOSD）是一种导致多器官受累的自身炎症性疾病。我们旨在研究这些患者的情绪状态和健康相关生活质量（HRQoL）。
在这项研究中，纳入了 82 名 AOSD 患者和 82 名年龄和性别匹配的健康对照者。收集了入组患者的人口统计学和临床数据。使用医院焦虑抑郁量表（HADS）和医疗结局研究 36 项简短量表（SF-36）分别评估情绪状态和生活质量。采用 Spearman 相关和多变量线性回归分析评估与焦虑和抑郁相关的疾病相关危险因素。
纳入了 44 例活动期和 38 例缓解期患者。我们发现，活动期 AOSD 患者的 HADS 焦虑（HADS-A）和抑郁（HADS-D）亚量表评分均明显高于缓解期患者，且明显高于对照组。此外，HADS-A 与患者的总体评估（PGA）、疼痛和泼尼松剂量呈正相关，HADS-D 与全身评分、PGA 和疼痛呈正相关。女性、大剂量皮质类固醇和 PGA 评分大于 50 与 HADS-A 评分显著相关，而咽痛和 PGA 评分大于 50 与 HADS-D 评分显著相关。此外，AOSD 患者的焦虑和抑郁对 HRQoL 有负面影响。
活动期 AOSD 患者往往容易焦虑和抑郁，与缓解期患者相比，生活质量较差。因此，在 AOSD 患者的长期管理中应包括心理健康和 HRQoL 的评估。关键点：成人斯蒂尔病（AOSD）是一种导致多器官受累的系统性炎症性疾病。这是迄今为止首次发表的关于 AOSD 患者心理问题和健康相关生活质量（HRQoL）的研究。活动期 AOSD 患者较缓解期患者更容易焦虑和抑郁，生活质量较差。患者的焦虑和抑郁与 HRQoL 受损相关。
