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[类风湿关节炎患者的患病率及抑郁程度]

[Prevalence and depression degree in patients with rheumatoid arthritis].

作者信息

Pastor Oliver J F, Morales Suárez-Varela M, Llopis González A, Ferriol Casar V

机构信息

Servicio Medicina Interna, Hospital Universitario La Fe, Valencia.

出版信息

Med Clin (Barc). 1998 Oct 3;111(10):361-6.

PMID:9833237
Abstract

BACKGROUND

Study goals were: a) to know the existence and depressive level among a series of rheumatoid arthritis (RA) patients; b) to assess differences in depression levels of individuals with and without RA, and c) to identify the association of depression level with socioepidemiological, clinical, and prognostic characteristics in these patients.

MATERIAL AND METHODS

Cross-sectional study that undertakes a 3 years period (July 1992-March 1995) and includes 221 patients diagnosed of RA according to the 1988 criteria of the American College of Rheumatology (ACR). Association of depression levels, assessed with the Self-Rating Depression Scale of Zung-Conde, with each one of the variables was evaluated using chi 2 tests (p < 0.05). A multivariate analysis type Automatic Interaction Detection (AID), based on the statistic r2, was applied to determine patient's profile with RA and depression.

RESULTS

Depressive level was identified in 33.48% of patients. Odds ratio (OR) between "not depressive" and "depressive" levels was from 20.35 with 95% CI: 8.87-47.88 (p < 0.00001). Association was found with the variables sex (p < 0.0001), profession (p = 0.02), weight and height (p < 0.0001 in both variables), Ritchie index (p < 0.004), number of painful joints (p = 0.002), morning stiffness (p = 0.049) and secondary effects of the treatment (p = 0.034). Sex was the variable that most influenced in depressive level (p < 0.00001). In females group, the factor mainly related with depression was the number of painful joints (p < 0.0002) while in males, it was the self-rating pain valuation with a Likert scale (p < 0.0001).

CONCLUSIONS

RA could causes depression in the patients. The factor with highest influence in the depression of these patients was the sex. The most influential factor in the females was the number of painful joints, while in the males was the self-rating of pain.

摘要

背景

研究目标如下:a)了解一系列类风湿性关节炎(RA)患者中抑郁症的存在情况及抑郁程度;b)评估患RA和未患RA个体在抑郁水平上的差异;c)确定这些患者的抑郁水平与社会流行病学、临床及预后特征之间的关联。

材料与方法

本横断面研究为期3年(1992年7月至1995年3月),纳入了221例根据美国风湿病学会(ACR)1988年标准确诊为RA的患者。使用Zung-Conde自评抑郁量表评估抑郁水平,并通过卡方检验(p < 0.05)评估抑郁水平与每个变量之间的关联。基于统计量r2应用自动交互检测(AID)类型的多变量分析来确定RA和抑郁症患者的特征。

结果

33.48%的患者存在抑郁水平。“非抑郁”和“抑郁”水平之间的优势比(OR)为20.35,95%置信区间为:8.87 - 47.88(p < 0.00001)。发现与以下变量存在关联:性别(p < 0.0001)、职业(p = 0.02)、体重和身高(两个变量p均< 0.0001)、里奇指数(p < 0.004)、疼痛关节数(p = 0.002)、晨僵(p = 0.049)以及治疗的副作用(p = 0.034)。性别是对抑郁水平影响最大的变量(p < 0.00001)。在女性组中,与抑郁主要相关的因素是疼痛关节数(p < 0.0002),而在男性中,是用李克特量表进行的自评疼痛评估(p < 0.0001)。

结论

RA可能导致患者出现抑郁。这些患者抑郁的最主要影响因素是性别。女性中最有影响的因素是疼痛关节数,而男性中是疼痛自评。

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