Moudi Sousan, Heidari Behzad, Yousefghahari Behnaz, Gholami Reza, Gholinia Hemmat, Babaei Mansour
Health Research Center, Master of Biostatistics and Epidemiology, Babol University of Medical Science, Iran.
Clinical Research Development Unit of Rouhani, Babol University of Medical Sciences, Iran.
Reumatologia. 2023;61(2):86-91. doi: 10.5114/reum/154905. Epub 2023 Feb 1.
Depression and anxiety share similar symptoms with rheumatoid arthritis (RA) and these conditions are often not diagnosed or overlooked in RA. This study aimed to determine the prevalence of depression/anxiety in RA and their correlation with RA activity.
Rheumatoid arthritis patients who presented at a rheumatology clinic were selected consecutively. The diagnosis of RA was confirmed by the ACR/EULAR criteria, disease activity was assessed by Disease Activity Score based on the 28-joint count (DAS28) and patients with DAS28 > 2.6 were considered to have active RA. The diagnosis of depression and anxiety was made by the Hospital Anxiety and Depression Scale (HADS). The Pearson test was used to determine the correlation between DAS28 and HADS scores.
Two-hundred patients (female, 82%) with a mean age of 53.5 ±10.1 years and mean disease duration of 6.6 ±6.8 years were studied. Depression was diagnosed in 27 (13.5%) patients and anxiety in 38 (19%) patients. The DAS28 score correlated positively with depression ( = 0.173, = 0.014) and anxiety score ( = 0.229, = 0.001). In multiple logistic regression analysis after adjustment for all covariates, age < 40 years and female sex were independently associated with RA activity in patients with depression, with OR = 4.21 ( = 0.002) and OR = 3.56 ( = 0.028) respectively.
These findings indicate that depression and anxiety are prevalent in RA and correlate positively with active disease in particular in depressive female patients aged < 40 years.
抑郁症和焦虑症与类风湿性关节炎（RA）有相似症状，这些情况在RA中常未被诊断或被忽视。本研究旨在确定RA中抑郁症/焦虑症的患病率及其与RA活动的相关性。
连续选取在风湿病诊所就诊的类风湿性关节炎患者。RA的诊断依据美国风湿病学会/欧洲抗风湿病联盟（ACR/EULAR）标准确定，疾病活动度通过基于28个关节计数的疾病活动评分（DAS28）进行评估，DAS28>2.6的患者被认为患有活动性RA。抑郁症和焦虑症的诊断采用医院焦虑抑郁量表（HADS）。采用Pearson检验确定DAS28与HADS评分之间的相关性。
研究了200例患者（女性占82%），平均年龄53.5±10.1岁，平均病程6.6±6.8年。27例（13.5%）患者被诊断为抑郁症，38例（19%）患者被诊断为焦虑症。DAS28评分与抑郁评分呈正相关（r = 0.173，P = 0.014），与焦虑评分也呈正相关（r = 0.229，P = 0.001）。在对所有协变量进行调整后的多因素logistic回归分析中，年龄<40岁和女性在抑郁症患者中与RA活动独立相关，OR分别为4.21（P = 0.002）和3.56（P = 0.028）。
这些发现表明，抑郁症和焦虑症在RA中普遍存在，并且与活动性疾病呈正相关，尤其是在年龄<40岁的抑郁女性患者中。
