Background Depression is common in rheumatoid arthritis (RA). The influences of depression on disease activity, self-efficacy and health status are not well assessed in patients with RA.
Objectives To assess the correlation of depression with disease activity including patient global assessment (PGA), self-efficacy, sleep disturbance and Quality of life (QOL) 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 depression group (CES-D 16≤) and non-depression group (CES-D16>) according to the Center for Epidemiological Studies Depression (CES-D) scale. Swollen joint count (SJC), tender joint count (TJC), evaluator global assessment (EGA), PGA and clinical disease activity index (CDAI) were assessed. Anxiety was assessed utilizing State-Trait Anxiety Inventory (STAI) and Hospital Anxiety and Depression Scale-Anxiety (HADS-A), while self-efficacy with General Self-Efficacy Scale (GSES), sleep disturbance with Pittsburgh Sleep Quality Index (PSQI) and QOL with Sort Form-36 (SF-36). The data was analyzed using Wilcoxon signed-rank test.
Results One hundred twelve patients (18 males and 94female) 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 dosage of prednisolone between depression group (n=28) and non-depression group (n=84) (p=0.4761, p=0.7829, p=0.4161, respectively). There was no significant difference in SJC, TJC and EGA between 2 groups (p=0.1651, p=0.0983, p=0.0601, respectively). However, PGA and CDAI were significantly lower in non-depression group (p<0.005 and p=0.0417, respectively). Similarly, STAI (state anxiety) was significantly lower non-depression group (p<0.0001). The rate of patients with anxiety assessed with HADS-A was significantly lower in non-depression group (p<0.0001), while GSES was significantly higher in non-depression group (p<0.05). The rate of patients with sleep disturbance assessed with PSQI was significantly lower in non-depression group (p<0.0001). In SF-36, there was no significant difference in physical component summary (PCS) between 2 groups (p=0.2101), while mental component summary (MCS) was significantly higher in non-depression group (p<0.0001).
Conclusions These data suggests that depression have undesirable influences on PGA, self-efficacy, sleep disturbance and mental phase of QOL in patients with RA. This study provides that supports for depressive state might be effective for improvement of PGA, self-efficacy, sleep disturbance and QOL in patients with RA.
Disclosure of Interest None Declared