Department of Psychiatry, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Necmettin Erbakan University, Konya, Turkey
Turk J Med Sci. 2021 Aug 30;51(4):1631-1639. doi: 10.3906/sag-2011-188.
BACKGROUND/AIM: The COVID-19 outbreak is known to increase stress levels of most patients with chronic diseases. Patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA) are highly susceptible to environmental stress. In the current study, we aimed to determine how the COVID-19 pandemic psychologically affected patients with chronic progressive diseases such as AS and RA and the effects of these psychological factors on disease activity.
Age and sex-matched patients with AS (n = 80), RA (n = 80), and healthy controls (n = 80) were included in the study. All participants were evaluated with the “Perceived COVID-19 Threat Form (PCTF)”, “Suicide-Ideation Scale (SIS)”, “Hospital Anxiety and Depression Scale (HADS)”, “The Ability to Cope with Trauma (PACT)”, and “Psychological General Well-Being Index (PGWB)” scales. BASDAI was used in patients with AS, and DAS28 was used in patients with RA to assess disease severity.
Compared to healthy individuals, patients with RA and AS had lower PGWB scores and higher HADS depression and anxiety subscale scores. Almost all psychometric assessment test scores were worse in AS patients with high-disease activity compared to those in low-disease activity. PACT scores were higher in patients with moderate RA compared to patients with mild RA (p = 0.006). While a positive correlation was identified between BASDAI and most of the psychometric assessment test scores (r = 0 .36 for PCTF, r = 0.53 for depressive scores, r = 0.54 for anxiety scores, r = 0.57 for suicidal ideation), DAS28 scores were found to be associated only with PACT total and PACT perceived forward-focused subscale scores (r = –.26 and r = .33, respectively).
Psychologically, AS and RA patients were found to be worse off compared to healthy controls. The perceived COVID threat and psychological status were associated with disease activity in AS, but not RA patients. Patients with chronic illnesses may be more vulnerable to the psychological effects of the pandemic, which can worsen disease activity.
背景/目的：众所周知，COVID-19 疫情会增加大多数慢性病患者的压力水平。患有强直性脊柱炎（AS）和类风湿关节炎（RA）的患者极易受到环境压力的影响。在本研究中，我们旨在确定 COVID-19 大流行如何在心理上影响 AS 和 RA 等慢性进行性疾病患者，以及这些心理因素对疾病活动的影响。
本研究纳入了 80 例 AS 患者、80 例 RA 患者和 80 例健康对照者。所有参与者均接受了“感知 COVID-19 威胁表（PCTF）”、“自杀意念量表（SIS）”、“医院焦虑抑郁量表（HADS）”、“创伤应对能力量表（PACT）”和“心理总体幸福感量表（PGWB）”评估。AS 患者采用 BASDAI 评估疾病严重程度，RA 患者采用 DAS28 评估疾病严重程度。
与健康个体相比，RA 和 AS 患者的 PGWB 评分较低，HADS 抑郁和焦虑分量表评分较高。与疾病活动度低的 AS 患者相比，几乎所有心理评估测试评分在疾病活动度高的 AS 患者中均较差。与轻度 RA 患者相比，中度 RA 患者的 PACT 评分较高（p = 0.006）。BASDAI 与大多数心理评估测试评分呈正相关（PCTF 为 r = 0.36，抑郁评分为 r = 0.53，焦虑评分为 r = 0.54，自杀意念评分为 r = 0.57），而 DAS28 评分仅与 PACT 总分和 PACT 感知向前聚焦分量表评分相关（r = -0.26 和 r = 0.33）。
与健康对照组相比，AS 和 RA 患者的心理状况更差。AS 患者的感知 COVID 威胁和心理状况与疾病活动度相关，但 RA 患者无此关联。患有慢性疾病的患者可能更容易受到疫情的心理影响，这可能会使疾病活动度恶化。
