Background Recent effective treatment with disease-modifying anti-rheumatic drugs (DMARDs) including biologic DMARDs (bDMARDs) improved the disease control of patients with rheumatoid arthritis (RA), and the change of body image of the patients might influenced the surgical indication. Body image assessment tool (BIAT) has been reported to be a reliable and valid tool1). Patients with RA had a worse body image than individuals without RA2), however, there are no evidence showed the body image of patients who requires surgical intervention.
Objectives The current study aimed to investigate the body image of patients who requires surgical intervention and to examine the correlation with depressive condition.
Methods 163 patients (16 male, 147 female) with RA were divided into two groups of patients who didn't require the surgical intervention (non-operative group) and who underwent surgery (operative group). The non-operative group and operative group included 88 and 75 patients, respectively. The mean age of the non-operative and operative group were 64.8 and 64.4 years, and the mean disease duration were 17.5 and 22.7 years, respectively. The clinical evaluation included the use of bDMARDs, pain VAS (0–100mm), Health Assessment Questionnaire Disability Index (HAQ-DI), disease activity (DAS28-CRP), depression assessed by Beck Depression Inventory-II (BDI-II), and body image assessed by BIAT. Statistical analyses were performed using the Mann-Whitney U test, and Fisher's exact test.
Results The rate of use of bDMARDs was not significant between non-operative and operative group. In the operative group, pain VAS, HAQ-DI, DAS28-CRP and BDI-II were significantly higher (p<0.01, p<0.01, p<0.01 and p=0.02, respectively) and BIAT was significantly lower (p=0.02) when compared with non-operative group. Higher BDI-II significantly correlated with lower BIAT in both non-operative (r=-0.69, p<0.01) and operative group (r=-0.61, P<0.01).
Conclusions The result of this survey found the body image of patients in operative group was disturbed than that of non-operative patients. Body image disturbance was highly correlated with depressive condition in both operative and non-operative patients. To assess the body image might be useful to understand the patients' expectation and proper indication of the surgery.
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Jorge RT, et al. Body image in patients with rheumatoid arthritis. Mod Rhematol, 2010; 20(5): 491–495.
Disclosure of Interest None declared