Ward M M
Veterans Affairs/Robert Wood Johnson Clinical Scholars Program, Palo Alto Veterans Affairs Medical Center, CA 94304.
J Rheumatol. 1994 Jun;21(6):1046-50.
To determine the extent to which mood in general, and depression in particular, may confound self-report measures of functional disability, pain, and global arthritis status among patients with rheumatoid arthritis (RA).
Twenty-four patients with RA were prospectively examined every 2 weeks for up to 60 weeks. At each examination, self-report measures of functional disability, pain, and global arthritis status were assessed using the Health Assessment Questionnaire, and the clinical measures of swollen and tender joint counts, duration of morning stiffness, grip strength, 50' walk time, and Westergren sedimentation rate were recorded. In addition, patients completed a questionnaire derived from the Profile of Mood States-B (POMS-B), which assessed positive and negative moods, and the Center for Epidemiologic Studies Depression Scale (CES-D) at each examination. The degree to which mood or depression confounded the self-report measures of functional disability, pain, and global arthritis status was estimated using pooled time series regression models that examined the relationship between changes in either mood or depression and changes in each self-report measure over the course of the study, while controlling for the effects of the clinical measures of arthritis activity.
Mood, as measured by the POMS-B scale, explained 2.0% or less of the variation in longitudinal changes in each of the self-report measures, after controlling for the effects of the clinical measures of arthritis activity. Depression, as measured by the CES-D, explained less than 2.0% of the variation in changes in functional disability, but explained 6.0 and 8.0% of the variation in changes in pain and global arthritis status, respectively.
Depression may confound self-reports of pain and global arthritis status somewhat, but appears to have minimal influence on self-reported functional disability.
确定一般情绪，尤其是抑郁，在多大程度上可能混淆类风湿关节炎（RA）患者功能残疾、疼痛及整体关节炎状况的自我报告测量结果。
对24例RA患者进行前瞻性研究，每2周检查一次，为期60周。每次检查时，使用健康评估问卷评估功能残疾、疼痛及整体关节炎状况的自我报告测量结果，并记录肿胀和压痛关节计数、晨僵持续时间、握力、50英尺步行时间及魏氏血沉率等临床测量结果。此外，患者在每次检查时完成一份源自情绪状态剖面图B（POMS-B）的问卷，该问卷评估正性和负性情绪，以及流行病学研究中心抑郁量表（CES-D）。使用汇总时间序列回归模型估计情绪或抑郁对功能残疾、疼痛及整体关节炎状况自我报告测量结果的混淆程度，该模型在研究过程中检查情绪或抑郁变化与各自我报告测量结果变化之间的关系，同时控制关节炎活动临床测量结果的影响。
在控制关节炎活动临床测量结果的影响后，以POMS-B量表测量的情绪，解释了各自我报告测量结果纵向变化中2.0%或更少的变异。以CES-D测量的抑郁，解释了功能残疾变化中不到2.0%的变异，但分别解释了疼痛和整体关节炎状况变化中6.0%和8.0%的变异。
抑郁可能在一定程度上混淆疼痛和整体关节炎状况的自我报告，但似乎对自我报告的功能残疾影响极小。
