Article

The relationship between psychological distress and traditional clinical variables: a 2 year prospective study of 216 patients with early rheumatoid arthritis.

Department of Behavioural Sciences in Medicine, University of Oslo, Norway.
British journal of rheumatology 12/1997; 36(12):1304-11. DOI: 10.1093/rheumatology/36.12.1304
Source: PubMed

ABSTRACT In this longitudinal study (12 and 24 months follow-up) of 216 patients with early rheumatoid arthritis (RA) (< or = 4 yr duration), we assessed the strength and stability of the relationship between psychological distress and traditional clinical variables examined the ability of these clinical variables to predict changes in mental distress, and explored the directionality between mental distress and the other clinical variables. Study variables were symptoms of anxiety and depression measured by the Arthritis Impact Measurement Scales, tender joint counts, erythrocyte sedimentation rate (ESR), and self-reported pain and disability. Psychological distress showed high levels of stability over time. Pain and disability were the two variables most strongly and consistently related to mental distress. High levels of disability predicted an increase in depression during the next year; otherwise, changes in psychological distress were not predicted by disease-related variables. Attempts at causal modelling of the temporal relationship between mental distress, pain and disability failed to yield consistent results.

Full-text

Available from: Torbjorn Moum, Jun 05, 2015
0 Followers
 · 
41 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to evaluate the factors responsible for depressed mood in rheumatoid arthritis (RA). Clinical and laboratory measures were collected from 4558 RA patients enrolled in a large clinical cohort study for RA conducted at the Institute of Rheumatology, Tokyo Women’s Medical University (IORRA study). A two-question depressed screening included in the U.S. Preventive Services Task Force recommendation were utilized to identify “depressed patients.” A total of 1875 (41.1%) were identified as “depressed patients” who presented with symptoms suggestive of depression. Patient’s Visual Analog Scale (VAS) for general health (43.3 mm vs 24.6 mm, P < 0.0001) and pain (40.9 mm vs 23.8 mm, P < 0.0001) and the disability index scores measured by the Health Association Questionnaire (HAQ) (0.986 vs 0.574, P < 0.0001) were significantly higher in depressed patients than in nondepressed patients. The presence of three or more comorbidities (odds ratio [OR] 2.157, P < 0.0001), infection (OR 1.754, P < 0.0001), and joint surgery (OR 1.878, P < 0.0001) were significantly correlated with depressed mood in RA. The results of the Generalized Linear Model analysis showed that HAQ disability index (P < 0.0001) and patient’s VAS for general health (P < 0.0001) were also strongly and significantly associated to the response variable “probability of depressed patients.’ Patient appraisal of poor general health and greater disability were associated with depressed mood in RA.
    Modern Rheumatology 01/2014; 16(3). DOI:10.3109/s10165-006-0475-5 · 2.21 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study examined the extent to which illness perceptions, coping and disease indicators predict physical, social and psychological adjustment in patients with rheumatoid arthritis. Baseline data were collected on 75 women attending an out-patient clinic in the West of Ireland. Disease status was assessed by physician ratings of joint involvement, and laboratory indices of erythrocyte sedimentation rate and C-reactive protein. The Illness Perception Questionnaire, the COPE, the Coping Efficacy Scale and the Arthritis Impact Measurement Scale were administered during a semi-structured interview. In stepwise regression analyses (p < .01) illness perceptions accounted for 17% to 28% of the variance on measures of physical function, pain, depression and anxiety. All relationships were in the expected direction. Disease status explained variance on the illness-related aspects of physical function (21%) and coping predicted social activity (16%). Interventions based on understanding and modifying illness perceptions may prove useful in facilitating patient well-being.
    11/2012; 26(3):161-176. DOI:10.1080/03033910.2005.10446218
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Aim of the work To assess the effect of clinical manifestations, disease activity and medications on health-related quality of life (HRQoL) among patients with early rheumatoid arthritis (RA). Patients and methods Twenty-six early RA patients (mean age 43.31 ± 10.51 years, disease duration: 16.5 ± 5.2 months) diagnosed according to the 2010 RA classification criteria were recruited from the outpatient clinic of the Rheumatology and Rehabilitation Department, Sohag University, and 22 age and sex matched healthy persons participated in a case control study. Demographic data were taken from all participants in the study. The 36-item short-form health survey (SF-36) and Hamilton Anxiety Rating Scale (HAM-A) were assessed as measures of HRQoL and psychiatric comorbidity for both patients and controls. Disease activity in RA was assessed using the disease activity score (DAS28). Scoring algorithms were applied to produce the physical and mental component scores (PCS and MCS). Results There was statistically significant difference in the total SF36 score, anxiety and depression scores of HAM-A scale between patients and controls. The PCS showed the highest significant difference (p < 0.0001), followed by SF36 (p = 0.01) and MCS (p = 0.024). There were no significant differences according to the age, gender, occupation or level of education of the patients. Anxiety and depression scores significantly correlated with the bodily pain and DAS28 scores and inversely with the PCS and MCS. The DAS28 strongly negatively correlated with the PCS and MCS. Conclusion Rheumatoid arthritis has a major impact on many areas of an individual’s life and tends to have a profound impact on the health-related quality of life.
    04/2014; 36(2). DOI:10.1016/j.ejr.2013.12.004