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AB0795 Hospital anxiety and depression scale (hads) is a ‘non-discriminatory’ patient related outcome measure (prom) in a rheumatology long term condition (ltc) clinic
  1. Z. Fattah1,
  2. S. Chita2,
  3. P. Charalambous3,
  4. C. B. Colaço4
  1. 1Rheumatology, University College London Hospital NHS Trust
  2. 2Research and Development, North West London Hospitals Trust
  3. 3Central Middlesex Hospital, London, United Kingdom
  4. 4Rheumatology, Central Middlesex Hospital, London, United Kingdom


Background Patient related outcome measures (PROMs) in research settings require vital but often complex activity scores, within which high levels of anxiety and depression scores (HADS) affecting physical and emotional quality of life in SLE and RA are noted (1,2). Hanly and colleagues (3) show significant neuropsychiatric manifestations are common in SLE and RA at a similar frequency (SLE 53%; RA 48%; p = 0.75). We examined the discriminatory value of quick self-completed HADS questionnaires in a single-handed Rheumatology Long Term Condition outpatient setting in London.

Objectives This service audit was to assess the levels of anxiety and depression in Rheumatology Long Term Condition Clinics and to clarify if HADS score can differentiate patients with Neuropsychiatric SLE (NPSLE).

Methods 224 patients of 16-90 years age range with any Long Term Condition attending rheumatology clinics at Central Middlesex Hospital self-completed HADS questionnaire. HADS scores: normal (0-7), mild (8-10), moderate (11-15) and severe (16-21). Data was then matched to SLE patients, RA patients and a group of miscellaneous patients with LTC. Additionally the SLE group was split into two subgroups, SLE and NPSLE.

Results There was no significant difference in self reported anxiety levels between (SLE), (RA) or (Misc), irrespective of age. Counter to expectation there was no difference in the level of anxiety or depression between SLE (n=56) and NPSLE (n=33) subgroups as illustrated by tables 1 and 2.

Conclusions These relatively good outcomes in SLE/NPSLE may support the intense medical intervention model for autoimmune disease. However, individuals detected by the screen may also benefit from targeted therapy. These simply administered PROMs may allow resource management of Rheumatology LTC with follow up assessment to determine value for money.

  1. Wekking EM. Psychiatric symptoms in systemic lupus erythematosus; an update. Psychosom Med1993; 55: 219–28.

  2. Gandey A. Mental Health problems frequently overlooked in lupus. Medscape Medical News; 2005

  3. Hanly JG, Fisk JD, McCurdy G, Fougere L, Neuropsychiatric syndromes in patients with systemic lupus erythematosus and rheumatoid arthritis. J Rheumatology. 2005 Aug; 32(8): 1459-6.

Acknowledgements Mr Paul Bassett (Statistician), Dr Swati Shukla and Dr Bushra Kohaji (All helped in data gathering and processing).

Disclosure of Interest None Declared

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