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AB0385 Clinical and Subclinical Neuropsychiatric Abnormalities in Rheumatoid Arthritis Patients
  1. E. M Khedr1,
  2. N. Abo El Fetoh1,
  3. O. Herdan2,
  4. D.H. El-Hammady3,
  5. R. M Gamal4,
  6. H. Khalifa1,
  7. A. M Ali1
  1. 1Neurology and Psychiatry Department
  2. 2Rheumatology Unit, Department of Internal Medicine
  3. 3Assiut university hospital, Assiut, Egypt
  4. 4Rheumatology and Rehablitation departement, Assiut university hospital, Assiut, Egypt

Abstract

Background Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory disease with probable autoimmune aetiology. RA has many secondary complications and a variety of neuropsychological consequences

Objectives To estimate the frequencies of neuropsychiatric disorders in RA patients and their relation with the duration and activity of disease.

Methods Seventy four consecutive female, RA patients were recruited and compared with 25 age and educational status-matched female healthy volunteers. All eligible participants underwent clinical, laboratory and electrophysiological examinations (motor and sensory nerve conduction study, F-wave of four Limbs, P300 Event related Potential (ERP) and electroencephalography (EEG). Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders 3rd edition, Revised (DSM-III-R) Axis I Disorders (SCID-I) for diagnosis of psychiatric illness and Wechsler Adult Intelligence scale 3rd edition (WAIS-III) with assessment of total scale, verbal and performance intelligence quotients (IQ)were administered to all participants.

Results Fourteen patients (18.9%) had evidence of symptomatic peripheral neuropathy and radiculopathy, while 60.8% had psychiatric disorders. Depression was the most prevalent psychiatric disorder (45%), followed by anxiety (27%) and comorbid anxiety with depression (21.6%). low IQ score was recorded in 54%. P300 latency was significantly prolonged (p=0.0001) and seven (9.5%) RA patients recorded abnormal P300 latency (>mean ± 2SD) compared to control values. Abnormal electroencephalography (EEG) findings were observed in 48.6%. VAS pain score was significantly higher among patients with psychiatric disorders versus patients without psychiatric disorders (p=0.0001). Significant negative correlation was recorded between disease activity score and total IQ (p=0.01), while no significant association between with the disease activity score with the presence of neuropathy or psychiatric disorders.

Conclusions Cognitive impairment, depression, anxiety and peripheral neuropathy are common in RA patients. Early diagnosis and management of neuropsychiatric disorders in RA patients may greatly improve the patients' health related quality of life.

Disclosure of Interest None declared

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