Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Department of Physical Therapy, Cairo University, Cairo, 11835, Egypt.
Sci Rep. 2024 May 20;14(1):11513. doi: 10.1038/s41598-024-61523-3.
Depression and anxiety often coexist with rheumatoid arthritis (RA) and affect the course of the disease. These mental health conditions can be overlooked or underdiagnosed in people with RA. There is conflicting evidence in previous studies regarding this topic, indicating that further research is necessary to provide a thorough understanding of the relationship between anxiety, depression, and RA. This study aims to determine the factors correlated with depression and anxiety symptoms in RA patients by evaluating disease activity at the same time. This cross-sectional study was conducted at four outpatient rehabilitation centers in four Syrian provinces: Damascus, Homs, Hama, and Latakia. The study included RA patients who attended the RA department of rehabilitation centers from January 1 to June 31, 2023. RA patients who presented at a rheumatology clinic were selected consecutively. RA patients were included in the study in accordance with the ACR/EULAR classification 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 demographic data, as well as disease duration, educational status, Disease Activity Score with 28-joint counts (DAS28), health assessment questionnaire (HAQ) score, and the hospital anxiety and depression scale (HADS), were the parameters used in the analysis. Two hundred and twelve patients (female, 75%) with a mean age of 49.3 ± 13.1 years and a mean disease duration of 8.3 ± 6.9 years were studied. Depression was diagnosed in 79 (37.3%) patients and anxiety in 36 (16.9%) patients. Patients with depression and/or anxiety had higher HAQ and DAS28 scores compared to other RA patients. Blue-collar workers exhibited a higher prevalence of anxiety, whereas females, housewives, and individuals with lower educational attainment demonstrated a higher prevalence of depression. The current study found high rates of anxiety and depression in RA patients, highlighting the significant burden of these mental health conditions compared to the general population. It is essential for healthcare providers not to overlook the importance of psychiatric evaluations, mental health assessments, and physical examinations of RA patients.
抑郁和焦虑常常与类风湿关节炎（RA）并存，并影响疾病的进程。在 RA 患者中，这些心理健康状况可能被忽视或诊断不足。先前的研究中对此主题存在相互矛盾的证据，表明需要进一步研究以全面了解焦虑、抑郁和 RA 之间的关系。本研究旨在通过同时评估疾病活动来确定与 RA 患者抑郁和焦虑症状相关的因素。这项横断面研究在叙利亚的四个省份（大马士革、霍姆斯、哈马和拉塔基亚）的四个门诊康复中心进行。研究包括 2023 年 1 月 1 日至 6 月 31 日期间在康复中心 RA 部门就诊的 RA 患者。在风湿病诊所就诊的 RA 患者连续入选。符合 ACR/EULAR 分类标准的 RA 患者被纳入研究，疾病活动通过 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期 RA。分析中使用的参数包括人口统计学数据、疾病持续时间、教育程度、28 个关节计数的疾病活动评分（DAS28）、健康评估问卷（HAQ）评分和医院焦虑抑郁量表（HADS）。共研究了 212 名患者（女性，75%），平均年龄为 49.3±13.1 岁，平均疾病持续时间为 8.3±6.9 年。79 名（37.3%）患者被诊断为抑郁，36 名（16.9%）患者被诊断为焦虑。与其他 RA 患者相比，患有抑郁和/或焦虑的患者 HAQ 和 DAS28 评分更高。蓝领工人焦虑症的患病率较高，而女性、家庭主妇和受教育程度较低的人抑郁症的患病率较高。本研究发现 RA 患者中焦虑和抑郁的发生率较高，这表明与一般人群相比，这些心理健康状况对患者的负担显著。对于医疗保健提供者来说，不应忽视对 RA 患者进行精神病评估、心理健康评估和身体检查的重要性。
