Kim Hee Jun, Jung Ju-Yang, Kim Ji-Won, Suh Chang-Hee, Kim Hyoun-Ah
School of Nursing, The George Washington University, Washington, DC, USA.
Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea.
J Rheum Dis. 2025 Jan 1;32(1):38-47. doi: 10.4078/jrd.2024.0074. Epub 2024 Sep 4.
Pain is a significant and debilitating symptom of rheumatoid arthritis (RA) that significantly affects the quality of life and functional ability of patients. In the present study, we examined the association between pain variables and disease activity markers in patients with RA.
We enrolled 133 patients with RA and assessed their clinical characteristics, socioeconomic and psychological factors, and pain measures. The psychological factors assessed included depressive symptoms and pain catastrophizing.
The study cohort comprised predominantly female patients with RA with an average age of 55.5±10.1 years. Depressive symptoms had a mean score of 5.83±4.71, while pain catastrophizing had an average score of 14.36±10.70. The mean scores for pain intensity, and pain interference, were 2.98±1.75 and 19.54±16.17, respectively, with significant positive correlations observed with depressive symptoms. Hemoglobin and hematocrit levels were negatively correlated with pain intensity. Multivariable linear regression analysis revealed significant associations between depressive symptoms and pain intensity, catastrophizing, and interference. Other factors associated with pain intensity included tender joint count. Pain catastrophizing was associated with education and economic status. Pain interference was associated with sex and economic status.
This study shows the influence of disease-related indicators and psychological factors on pain in patients with RA, with depressive symptoms playing a crucial role in predicting pain experience. Effective pain management strategies for RA should include the management of depressive symptoms, in addition to addressing disease-related indicators.
疼痛是类风湿关节炎（RA）的一种显著且使人衰弱的症状，严重影响患者的生活质量和功能能力。在本研究中，我们调查了RA患者疼痛变量与疾病活动标志物之间的关联。
我们招募了133例RA患者，评估了他们的临床特征、社会经济和心理因素以及疼痛指标。评估的心理因素包括抑郁症状和疼痛灾难化。
研究队列主要由平均年龄为55.5±10.1岁的女性RA患者组成。抑郁症状的平均评分为5.83±4.71，而疼痛灾难化的平均评分为14.36±10.70。疼痛强度和疼痛干扰的平均评分分别为2.98±1.75和19.54±16.17，与抑郁症状呈显著正相关。血红蛋白和血细胞比容水平与疼痛强度呈负相关。多变量线性回归分析显示抑郁症状与疼痛强度、灾难化和干扰之间存在显著关联。与疼痛强度相关的其他因素包括压痛关节计数。疼痛灾难化与教育程度和经济状况有关。疼痛干扰与性别和经济状况有关。
本研究显示了疾病相关指标和心理因素对RA患者疼痛的影响，抑郁症状在预测疼痛体验中起关键作用。RA的有效疼痛管理策略除了应对疾病相关指标外，还应包括抑郁症状的管理。
