Background Patient global assessment (PGA) and evaluator global assessment (EGA) often differ in their perceptions in patients with rheumatoid arthritis (RA).
Objectives The purpose of this study was to examine the correlation of psychological state on PGA and EGA in patients with RA.
Methods Patients with RA were enrolled from Yukioka Hospital and NTT West Osaka Hospital, in Japan. The patients were divided to PGA remission group (PGA=<1) and non-remission group (PGA>1). The patients were also divided to EGA remission group (EGA=<1) and non-remission group (EGA>1). Disease activity was assessed with swollen joint counts (SJC), tender joint counts (TJC) and clinical disease activity index (CDAI). Depression was assessed with the Hospital Anxiety and Depression Scale-anxiety (HADS-A), anxiety with the State-Trait Anxiety Inventory (STAI) and sleep disturbance with Pittsburgh Sleep Quality Index (PSQI). These data were compared between 2 groups in PGA and EGA, respectively. The data was analyzed using Wilcoxon signed-rank test.
Results One hundred twelve patients (18 males and 94 female) were assessed. Baseline characteristics were as follows: median [range] of age (55.5, [26-83] years old), duration (8.59, [0.25-48] years), SJC (1, [0-25]), TJC (1, [0-17]), PGA (19, [0-84]), EGA (14, [0-88]) and CDAI (6.85, [0-54.2]), respectively. There was no significant difference in age, duration and PSL dosage between PGA remission group (n=35) and non-depression group (n=77) (p=0.7727, p=0.5446, p=0.1516, respectively). Similarly, there was no significant difference between EGA remission group (n=38) and non-remission group (n=74) in age, duration and PSL dosage (p=0.6804, p=0.3565, p=0.0548, respectively). SJC, TJC, EGA and CDAI were significantly lower in PGA remission group(p<0.0001, p<0.0001, p<0.0001 and p<0.0001, respectively). Similarly, EGA remission group was significantly lower in SJC, TJC, PGA and CDAI (p<0.0001, p<0.0001, p<0.0001 and p<0.0001, respectively). There is no significant difference in STAI (trait) between 2 groups both in PGA and EGA (p=0.9884 and p=0.4896, respectively). However, STAI (state) was significantly lower in PGA remission group (p<0.05), while no significant difference was found between 2 groups in EGA in STAI (state) (p=0.2463). Similarly in HADS-D, the rate of patients with depression was significantly lower in PGA remission group (p<0.05)while no significant difference was found between 2 groups in EGA (p=0.2522). There was no significant difference in PSQI between 2 groups both in PGA and EGA (p=0.7542 and p=0.2094, respectively).
Conclusions The discrepancy between PGA and EGA in patients with RA might be partially explained by the difference of psychological state. This study suggests that supports for psychological state may be effective for improvement of PGA.
Disclosure of Interest None Declared
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