Geng Y, Song Z B, Zhang X H, Deng X R, Wang Y, Zhang Z L
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Dec 18;52(6):1048-1055. doi: 10.19723/j.issn.1671-167X.2020.06.010.
To determine the prevalence of depression and anxiety in patients with psoriatic arthritis (PsA), to investigate whether there is a difference in the prevalence of depression and anxiety between PsA and rheumatoid arthritis (RA) patients and to identify associated risk factors for depression and anxiety in PsA patients.
PsA and RA patients who visited Department of Rheumatology and Clinical Immunology in Peking University First Hospital from May 2018 to Sep 2019 were recruited. Self-rating anxiety scale and self-rating depression scale were surveyed and compared between PsA and RA patients. Demographics and clinical features including age, gender, disease duration, disease activity score, psoriasis area and severity index (PASI), and medical application were collected. Power Doppler and grey-scale ultrasound of joints, tenosynovitis and enthesis were performed. Multivariate Logistic regression was used to identify the factors associated with mood disorders and the odds ratio of depression and anxiety between the PsA and RA patients.
Among the 114 enrolled PsA patients, 37 (32.5%) had mood disorders, in which 36 (31.6%) with depression and 15 (13.2%) with anxiety. Compared with 201 RA patients, PsA patients showed greater odds for depression [adjusted (95%): 2.7 (1.1-6.4)]. Depression was more often observed in the PsA than in the RA patients (31.6% . 18.9%, =0.011). The similar trend for anxiety was also observed, although the difference was insignificant (13.2% . 8.5%, =0.185). Age (=0.95, =0.008), psoriasis duration (=0.94, =0.018), pain visual analogue scale (=1.47, =0.011), PASI score (=1.07, =0.007) and presence of ultrasound enthesitis (=4.13, =0.009) were identified as factors associated with depression in the PsA patients. PASI score (=1.07, =0.001) was identified as associated factor for anxiety in the PsA patients.
The prevalence of depression and anxiety is elevated in PsA patients. Depression is significantly more prevalent in PsA patients than in RA patients. Younger age, shorter psoriasis duration, worse pain and presence of ultrasound enthesitis are associated with depression, while severe psoriasis rash is associated with both depression and anxiety in PsA patients.
确定银屑病关节炎（PsA）患者中抑郁和焦虑的患病率，调查PsA患者与类风湿关节炎（RA）患者在抑郁和焦虑患病率上是否存在差异，并确定PsA患者抑郁和焦虑的相关危险因素。
招募2018年5月至2019年9月期间在北京大第一医院风湿免疫科就诊的PsA和RA患者。对PsA和RA患者进行自评焦虑量表和自评抑郁量表调查并比较。收集人口统计学和临床特征，包括年龄、性别、病程、疾病活动评分、银屑病面积和严重程度指数（PASI）以及用药情况。对关节、腱鞘炎和附着点进行能量多普勒和灰阶超声检查。采用多因素Logistic回归分析确定与情绪障碍相关的因素以及PsA和RA患者抑郁和焦虑的比值比。
在114例纳入研究的PsA患者中，37例（32.5%）存在情绪障碍，其中36例（31.6%）有抑郁，15例（13.2%）有焦虑。与201例RA患者相比，PsA患者抑郁的几率更高[调整后比值比（95%置信区间）：2.7（1.1 - 6.4）]。PsA患者中抑郁的发生率高于RA患者（31.6%对18.9%，P = 0.011）。焦虑也有类似趋势，尽管差异不显著（13.2%对8.5%，P = 0.185）。年龄（β = 0.95，P = 0.008）、银屑病病程（β = 0.94，P = 0.018）、疼痛视觉模拟评分（β = 1.47，P = 0.011）、PASI评分（β = 1.07，P = 0.007）和超声显示附着点炎（β = 4.13，P = 0.009）被确定为PsA患者抑郁的相关因素。PASI评分（β = 1.07，P = 0.001）被确定为PsA患者焦虑的相关因素。
PsA患者抑郁和焦虑的患病率升高。PsA患者中抑郁的患病率显著高于RA患者。年龄较小、银屑病病程较短、疼痛较重和存在超声附着点炎与抑郁相关，而严重的银屑病皮疹与PsA患者的抑郁和焦虑均相关。
