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Health-related quality of life and its associations with mood condition in familial Mediterranean fever patients

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Abstract

The aim of the present study was to investigate the health-related quality of life (HRQOL) and mood conditions in familial Mediterranean fever (FMF) patients. Ninety FMF patients (F/M 60/30, median age 29) and 67 control subjects (F/M 46/21, median age 30) were included in this study. HRQOL was assessed with short form-36 (SF-36) and mood conditions were assessed with hospital anxiety depression scale (HADS). FMF patients had significantly lower mean scores on SF-36 physical components compared to the control group. However, mental components were comparable between groups. FMF patients were significantly more likely to have depression and anxiety compared to the control group [30 (33%) vs. 8 (12%), respectively, χ 2 = 9.58, OR (95% CI) = 3.7 (1.5–8.7), p < 0.01 for depression and 48 (53%) and 11 (16%), respectively, χ 2 = 22.31, OR (95% CI) = 5.8 (2.7–12.5), p < 0.001 for anxiety]. When frequency of anxious subjects was adjusted for the presence of concomitant depressive status as a confounding factor, the difference between the groups remained statistically significant [χ 2 = 11.86, OR (95% CI) = 5.4 (2.1–13.7), p < 0.01]. However, the difference of depression status between groups was not statistically significant when adjusted for the presence of concomitant anxiety status [χ 2 = 0.08, OR (95% CI) = 1.3 (0.5–3.8), p = 0.78] and FMF was found to be independently associated with only anxiety [OR (95% CI) = 7.1 (2.3–20.3)]. In addition, pure anxious FMF subgroup had significantly lower scores of mental health and mental component summary when compared to normal mood subgroup. In conclusion, FMF might adversely affect HRQOL. Depression and anxiety are more frequent in FMF patients than healthy subjects.

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References

  1. Alonso J, Ferrer M, Gandek B, Ware JE Jr, Aaronson NK, Mosconi P, Rasmussen NK, Bullinger M, Fukuhara S, Kaasa S, Leplège A, IQOLA Project Group (2004) Health-related quality of life associated with chronic conditions in eight countries: results from the International Quality of Life Assessment (IQOLA) Project. Qual Life Res 13:283–298

    Article  PubMed  Google Scholar 

  2. Benton T, Staab J, Evans DL (2007) Medical co-morbidity in depressive disorders. Ann Clin Psychiatry 19:289–303

    Article  PubMed  Google Scholar 

  3. Stoudemire A (1996) Epidemiology and psychopharmacology of anxiety in medical patients. J Clin Psychiatry 57(Suppl 7):64–72 73–75

    PubMed  Google Scholar 

  4. Isik A, Koca SS, Ozturk A, Mermi O (2007) Anxiety and depression in patients with rheumatoid arthritis. Clin Rheumatol 26:872–878

    Article  PubMed  Google Scholar 

  5. Hanly JG, Fisk JD, McCurdy G, Fougere L, Douglas JA (2005) Neuropsychiatric syndromes in patients with systemic lupus erythematosus and rheumatoid arthritis. J Rheumatol 32:1459–1466

    PubMed  Google Scholar 

  6. Martindale J, Smith J, Sutton CJ, Grennan D, Goodacre L, Goodacre JA (2006) Disease and psychological status in ankylosing spondylitis. Rheumatology (Oxford) 45:1288–1293

    Article  CAS  Google Scholar 

  7. Mancuso CA, Peterson MG, Charlson ME (2000) Effects of depressive symptoms on health related quality of life in asthma patients. J Gen Intern Med 15:301–310

    Article  PubMed  CAS  Google Scholar 

  8. Ozcetin A, Ataoglu S, Kocer E, Yazici S, Yildiz O, Ataoglul A, Icmeli C (2007) Effects of depression and anxiety on quality of life of patients with rheumatoid arthritis, knee osteoarthritis and fibromyalgia syndrome. West Indian Med J 56:122–129

    Article  PubMed  CAS  Google Scholar 

  9. Keystone E, Burmester GR, Furie R, Loveless JE, Emery P, Kremer J, Tak PP, Broder MS, Yu E, Cravets M, Magrini F, Jost F (2008) Improvement in patient-reported outcomes in a rituximab trial in patients with severe rheumatoid arthritis refractory to anti-tumor necrosis factor therapy. Arthritis Rheum 59:785–793

    Article  PubMed  CAS  Google Scholar 

  10. Revicki DA, Luo MP, Wordsworth P, Wong RL, Chen N, Davis JC Jr, ATLAS Study Group (2008) Adalimumab reduces pain, fatigue, and stiffness in patients with ankylosing spondylitis: results from the adalimumab trial evaluating long-term safety and efficacy for ankylosing spondylitis (ATLAS). J Rheumatol 35:1346–1353

    PubMed  CAS  Google Scholar 

  11. Ozen S (1999) New interest in an old disease: familial Mediterranean fever. Clin Exp Rheumatol 17:745–749

    PubMed  CAS  Google Scholar 

  12. Ozcakar L, Onat AM, Kaymak SU, Ureten K, Akinci A (2005) Selective serotonin reuptake inhibitors in familial Mediterranean fever: are we treating depression or inflammation? Rheumatol Int 25:319–320

    Article  PubMed  Google Scholar 

  13. Onat AM, Oztürk MA, Ozçakar L, Ureten K, Kaymak SU, Kiraz S, Ertenli I, Calgüneri M (2007) Selective serotonin reuptake inhibitors reduce the attack frequency in familial Mediterranean fever. Tohoku J Exp Med 211:9–14

    Article  PubMed  CAS  Google Scholar 

  14. Onat AM, Ozçakar L, Oztürk MA, Uçar G, Ureten K, Dagli N, Kiraz S, Ertenli I, Calgüneri M (2007) Plasma and platelet serotonin levels in familial Mediterranean fever. Clin Exp Rheumatol 25(4 Suppl 45):S16–S20

    PubMed  CAS  Google Scholar 

  15. Ressler KJ, Nemeroff CB (2000) Role of serotonergic and noradrenergic systems in the pathophysiology of depression and anxiety disorders. Depress Anxiety 12(Suppl 1):2–19

    Article  PubMed  Google Scholar 

  16. Livneh A, Langevitz P, Zemer D, Zaks N, Kees S, Lidar T, Migdal A, Padeh S, Pras M (1997) Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum 40:1879–1885

    Article  PubMed  CAS  Google Scholar 

  17. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483

    Article  PubMed  Google Scholar 

  18. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370

    Article  PubMed  CAS  Google Scholar 

  19. Ware JE Jr, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A (1995) Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results from the Medical Outcomes Study. Med Care 33(4 Suppl):264–279

    Google Scholar 

  20. Olssøn I, Mykletun A, Dahl AA (2005) The Hospital Anxiety and Depression Rating Scale: a cross-sectional study of psychometrics and case finding abilities in general practice. BMC Psychiatry 5:46

    Article  PubMed  Google Scholar 

  21. Pinar R (2005) Reliability and construct validity of the SF-36 in Turkish cancer patients. Qual Life Res 14:259–264

    Article  PubMed  Google Scholar 

  22. Aydemir O (1997) Validity and reliability of Turkish version of Hospital Anxiety and Depression Scale. Turk Psikiyatri Derg 8:280–287

    Google Scholar 

  23. Sutcigil L, Oktenli C, Musabak U, Bozkurt A, Cansever A, Uzun O, Sanisoglu SY, Yesilova Z, Ozmenler N, Ozsahin A, Sengul A (2007) Pro- and anti-inflammatory cytokine balance in major depression: effect of sertraline therapy. Clin Dev Immunol, article ID: 76396

  24. Penninx BW, Kritchevsky SB, Yaffe K, Newman AB, Simonsick EM, Rubin S, Ferrucci L, Harris T, Pahor M (2003) Inflammatory markers and depressed mood in older persons: results from the Health, Aging and Body Composition study. Biol Psychiatry 54:566–572

    Article  PubMed  CAS  Google Scholar 

  25. Bremmer MA, Beekman AT, Deeg DJ, Penninx BW, Dik MG, Hack CE, Hoogendijk WJ (2008) Inflammatory markers in late-life depression: results from a population-based study. J Affect Disord 106:249–255

    Article  PubMed  CAS  Google Scholar 

  26. Tuglu C, Kara SH, Caliyurt O, Vardar E, Abay E (2003) Increased serum tumor necrosis factor-alpha levels and treatment response in major depressive disorder. Psychopharmacology (Berl) 170:429–433

    Article  CAS  Google Scholar 

  27. Merendino RA, Di Rosa AE, Di Pasquale G, Minciullo PL, Mangraviti C, Costantino A, Ruello A, Gangemi S (2002) Interleukin-18 and CD30 serum levels in patients with moderate-severe depression. Mediators Inflamm 11:265–267

    Article  PubMed  Google Scholar 

  28. Reichenberg A, Yirmiya R, Schuld A, Kraus T, Haack M, Morag A, Pollmächer T (2001) Cytokine-associated emotional and cognitive disturbances in humans. Arch Gen Psychiatry 58:445–452

    Article  PubMed  CAS  Google Scholar 

  29. von Känel R, Hepp U, Kraemer B, Traber R, Keel M, Mica L, Schnyder U (2007) Evidence for low-grade systemic proinflammatory activity in patients with posttraumatic stress disorder. J Psychiatr Res 41:744–752

    Article  Google Scholar 

  30. Uguz F, Akman C, Kucuksarac S, Tufekci O (2009) Anti-tumor necrosis factor-alpha therapy is associated with less frequent mood and anxiety disorders in patients with rheumatoid arthritis. Psychiatry Clin Neurosci 63:50–55

    Article  PubMed  CAS  Google Scholar 

  31. Bagci S, Toy B, Tuzun A, Ates Y, Aslan M, Inal A, Gulsen M, Karaeren N, Dagalp K (2004) Continuity of cytokine activation in patients with familial Mediterranean fever. Clin Rheumatol 23:333–337

    Article  PubMed  Google Scholar 

  32. Simsek I, Pay S, Pekel A, Dinc A, Musabak U, Erdem H, Sengul A (2007) Serum proinflammatory cytokines directing T helper 1 polarization in patients with familial Mediterranean fever. Rheumatol Int 27:807–811

    Article  PubMed  CAS  Google Scholar 

  33. Haznedaroglu S, Ozturk MA, Sancak B, Goker B, Onat AM, Bukan N, Ertenli I, Kiraz S, Calguneri M (2005) Serum interleukin 17 and interleukin 18 levels in familial Mediterranean fever. Clin Exp Rheumatol 23(4 Suppl 38):S77–S80

    PubMed  CAS  Google Scholar 

  34. Erken E, Ozer HT, Gunesacar R (2006) Plasma interleukin-10 and interleukin-12 levels in patients with familial Mediterranean fever. Rheumatol Int 26:862–864

    Article  PubMed  CAS  Google Scholar 

  35. Buskila D, Zaks N, Neumann L, Livneh A, Greenberg S, Pras M, Langevitz P (1997) Quality of life of patients with familial Mediterranean fever. Clin Exp Rheumatol 15:355–360

    PubMed  CAS  Google Scholar 

  36. Brazier JE, Harper R, Jones NM, O’Cathain A, Thomas KJ, Usherwood T, Westlake L (1992) Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 305:160–164

    Article  PubMed  CAS  Google Scholar 

  37. Akar S, Can G, Binicier O, Aksu K, Akinci B, Solmaz D, Birlik M, Keser G, Akkoc N, Onen F (2008) Quality of life in patients with Takayasu’s arteritis is impaired and comparable with rheumatoid arthritis and ankylosing spondylitis patients. Clin Rheumatol 27:859–865

    Article  PubMed  Google Scholar 

  38. Kuriya B, Gladman DD, Ibañez D, Urowitz MB (2008) Quality of life over time in patients with systemic lupus erythematosus. Arthritis Rheum 59:181–185

    Article  PubMed  Google Scholar 

  39. Sherbourne CD, Wells KB, Meredith LS, Jackson CA, Camp P (1996) Comorbid anxiety disorder and the functioning and well-being of chronically ill patients of general medical providers. Arch Gen Psychiatry 53:889–895

    PubMed  CAS  Google Scholar 

  40. Saharinen T, Hintikka J, Niskanen L, Kylmä J, Honkalampi K, Nikkonen M, Haatainen K, Koivumaa-Honkanen H, Viinamäki H (2008) Health-related quality of life in a population-based sample of men with long-term mental symptoms. Nord J Psychiatry 62:106–112

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Section of Nephrology, Department of Internal Medicine, Gazi University Faculty of Medicine, Gazi University School of Medicine, Besevler, 06500, Ankara, Turkey

    Serpil Muge Deger

  2. Section of Rheumatology, Gazi University School of Medicine, Ankara, Turkey

    Mehmet Akif Ozturk, Mehmet D. Demirag, Berna Goker & Seminur Haznedaroglu

  3. Department of Psychiatry, Gazi University School of Medicine, Ankara, Turkey

    Selcuk Aslan

  4. Section of Rheumatology, Department of Internal Medicine, Gaziantep University School of Medicine, Ankara, Turkey

    A. Mesut Onat

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  1. Serpil Muge Deger
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Correspondence to Serpil Muge Deger.

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Deger, S.M., Ozturk, M.A., Demirag, M.D. et al. Health-related quality of life and its associations with mood condition in familial Mediterranean fever patients. Rheumatol Int 31, 623–628 (2011). https://doi.org/10.1007/s00296-009-1334-4

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  • DOI: https://doi.org/10.1007/s00296-009-1334-4

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