Background Rheumatoid arthritis (RA) is the prevalent autoimmune inflammatory arthritis found in adults, with the worldwide prevalence ranging from 0.4% to 1.3%. Psychological disorders can be underestimated in this population; on the other hand studies had shown that the daily experience with RA can lead to sleep, psychological and sleep disorders.
Objectives To characterize a population with RA and to describe the psychological, sexual and sleep disorders in a specialized rheumatology center in Bogotá Colombia.
Methods We perform a cross-sectional study of patients attending to our psychology consultation the information was collected through semi-structured interviews, also using classificatory criteria of pathologies described in CIE 10 diagnostic manual, applying descriptive epidemiology for continuous variables, measure of central tendency and dispersion for qualitative and categorical variables through percentages and averages.
Results We included 1398 patients attending to our psychology consultation. Mean age was 55 years ± 8; 80% were female and 20% male. Mean DAS28 was 2.6±1.3, mean HAQ was 1.6±1.6; patients had the disease for an average of 12 years ± 8; 41% of patients had comorbidities associated with non-autoimmune disease, 14% comorbidities related to autoimmune disease; 35% of our patients did not report other comorbidities. Most of patients were married 60%, followed by divorced 19%, single 14% and widowed 7%. Regarding occupation 33% were employees, 25% were housekeepers or retired due to age, 12% were retired due to disabilities, and 3% unemployed. Of the total population 45% had elementary school, 32% high school, 8% college education, 7% graduate education and 7% were illiterate. 17% of patients lived alone. Regarding psychological factors 25% had any mood disorders, 13% sleep disorders, 12% somatomorphic disorders, 6% sexual dysfunction, 2% dementia, 4% eating disorders and 38% reported no to have any of the above. Concerning sexual disorders, 38% reported no to have any sexual activity, 32% reported to have a satisfactory sexual life, 11% dyspareunia, 9% had an unsatisfactory sexual life, 5% loss of desire, 3% premature ejaculation and 2% orgasmic decrease. When the psychologist asked about sleep disorders 69% reported no to have any, 25% primary insomnia, 1% hypersomnia, 3% OSAS and 2% alterations on the circadian rhythm. There was a statistical association between psychological and sexual disorders, sleep and sexual disorders and, psychological and sleep disorders. Disease activity was associated only with sleep disorders.
Conclusions Not only DMARDs disease management should be a priority for RA patients, factors such as sleep, sexual and psychological are important because one third of patients have it; on the other hand there is a interdependence between them and disease activity. Thus, it is important to have a multidisciplinary care team for the patient with RA, including a psychologist that can manage this kind of conditions and if necessary refer to a psychiatrist consultation.
Disclosure of Interest None declared