Katz P P, Criswell L A
University of California, San Francisco 94143, USA.
Arthritis Care Res. 1996 Dec;9(6):441-8. doi: 10.1002/art.1790090605.
To determine if differences exist between men and women in their reports and evaluations of rheumatoid arthritis (RA) symptoms, and, if so, to identify explanations of those differences.
Data from a longitudinal panel study of persons with RA were used. Symptom reports were defined as individuals' evaluation of body states, e.g., evaluations of the severity of pain. Analyses were controlled for sociodemographic, clinical, and psychological characteristics.
In unadjusted analyses, women were more likely to evaluate their symptoms as severe. Adjustment for sociodemographic and clinical characteristics changed these results very little. Controlling for depressive symptoms decreased the magnitude of associations somewhat. Analyses controlling for additional respondent-reported clinical characteristics (Health Assessment Questionnaire score, number of painful joints) yielded dramatically different results; in no case did women evaluate their symptoms significantly more severely than men.
Our analyses suggest that women reported more severe symptoms, but that these differences may be due to more severe disease rather than a tendency by women to over-report symptoms or over-rate symptom severity. Future research should examine whether physicians respond to reports or prescribe treatments differently for men and women.
确定男性和女性在类风湿关节炎（RA）症状报告及评估方面是否存在差异，若存在差异，则找出这些差异的原因。
使用对类风湿关节炎患者进行纵向跟踪研究所得的数据。症状报告定义为个体对身体状况的评估，例如对疼痛严重程度的评估。分析对社会人口统计学、临床及心理特征进行了控制。
在未经调整的分析中，女性更倾向于将自身症状评估为严重。对社会人口统计学和临床特征进行调整后，这些结果变化甚微。控制抑郁症状后，关联程度有所降低。对其他由受访者报告的临床特征（健康评估问卷得分、疼痛关节数量）进行控制的分析得出了截然不同的结果；在任何情况下，女性对自身症状的评估都没有比男性明显更严重。
我们的分析表明，女性报告的症状更严重，但这些差异可能是由于病情更严重，而非女性有过度报告症状或高估症状严重程度的倾向。未来的研究应考察医生对男性和女性的症状报告是否有不同反应或是否开出不同的治疗方案。
