Department of Rheumatology, University Hospital of Tangier, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, Morocco.
Department of Epidemiology, Public Health and Social Sciences, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, Morocco.
Curr Rheumatol Rev. 2021;17(3):303-311. doi: 10.2174/1573397117666210127124544.
Patients with rheumatic diseases are more likely to suffer from anxiety, depression and insomnia. Yet, little is known about mental health status during COVID-19 pandemic.
This study aims to measure the prevalence of mental health disorders among patients with rheumatic diseases in the era of COVID-19 pandemic and to determine potential risk factors for major symptoms of depression, anxiety, and insomnia in participants.
Participants with rheumatic diseases were asked to complete a questionnaire using a telephonic interview. Sociodemographic and rheumatic disease characteristics were recorded. Mental health status was assessed by the patient health questionnaire-9 (PHQ-9), generalized anxiety disorder (GAD)-7, and insomnia severity index (ISI) questionnaires to detect depression, anxiety and insomnia symptoms, respectively.
We included 307 patients in the survey. Rheumatoid arthritis was the most frequent diagnosis (55%). Of all participants, 7.5% had known depression and 5.5% known anxiety. Mental health disorders were insomnia (34.9%), anxiety (33.2%), and depression (24.4%). Major symptoms of insomnia, anxiety, and depression were noted in respectively, 19.9%, 12.4%, and 7.8% of participants. Risk factors for major insomnia were male gender (OR= 4.36, 95% CI 2.06 to 9.25; p<0.0001), low socioeconomic status (OR= 2.64, 95% CI 1.44 - 4.83; p<0.002) and having rheumatoid arthritis (OR= 2.00, 95% CI 1.04 to 3.84; p<0.036). Major anxiety was associated with low monthly income (OR=1.79, 95% CI 1.07 to 3.01; p<0.026), and higher Numerical Rating Scale (NRS) of pain (OR=1.795, 95% CI 1.074 to 2.994 ; p<0.026). Major depression was associated with the worsening of rheumatic disease (OR=1.86, 95% CI 1.06 to 3.26; p<0.03).
A high frequency of undiagnosed depression, anxiety and insomnia symptoms was found in rheumatic patients. Rheumatologists should be aware of these comorbidities, especially in the era of COVID-19 pandemic.
患有风湿性疾病的患者更容易出现焦虑、抑郁和失眠。然而，目前对于 COVID-19 大流行期间的精神健康状况知之甚少。
本研究旨在测量 COVID-19 大流行期间风湿性疾病患者的精神健康障碍患病率，并确定参与者中主要抑郁、焦虑和失眠症状的潜在危险因素。
通过电话访谈，要求患有风湿性疾病的参与者完成一份问卷。记录社会人口统计学和风湿性疾病特征。使用患者健康问卷-9（PHQ-9）、广泛性焦虑症（GAD）-7 和失眠严重程度指数（ISI）问卷评估精神健康状况，以分别检测抑郁、焦虑和失眠症状。
我们共纳入 307 名患者进行调查。最常见的诊断是类风湿性关节炎（55%）。所有参与者中，已知患有抑郁症的占 7.5%，已知患有焦虑症的占 5.5%。精神健康障碍为失眠（34.9%）、焦虑（33.2%）和抑郁（24.4%）。分别有 19.9%、12.4%和 7.8%的参与者出现主要失眠、焦虑和抑郁症状。主要失眠的危险因素为男性（OR=4.36，95%CI 2.06 至 9.25；p<0.0001）、低社会经济地位（OR=2.64，95%CI 1.44 至 4.83；p<0.002）和患有类风湿性关节炎（OR=2.00，95%CI 1.04 至 3.84；p<0.036）。主要焦虑与低月收入（OR=1.79，95%CI 1.07 至 3.01；p<0.026）和更高的数字评分量表（NRS）疼痛评分（OR=1.795，95%CI 1.074 至 2.994；p<0.026）相关。主要抑郁与风湿性疾病恶化有关（OR=1.86，95%CI 1.06 至 3.26；p<0.03）。
风湿性疾病患者中发现了大量未经诊断的抑郁、焦虑和失眠症状。风湿病医生应该意识到这些合并症，特别是在 COVID-19 大流行期间。
