Depression Is a Major Determinant of Functional Capacity in Rheumatoid Arthritis

被引:8
作者
Isnardi, Carolina A. [1 ]
Capelusnik, Dafne [1 ]
Edith Schneeberger, Emilce [1 ]
Bazzarelli, Marcela [2 ]
Berloco, Laura [2 ]
Blanco, Eliana [3 ]
Benitez, Cristian A. [3 ]
Lujan Benavidez, Federico [3 ]
Scarafia, Santiago [4 ]
Lazaro, Maria A. [4 ]
Perez Alamino, Rodolfo [5 ]
Colombres, Francisco [5 ]
Kohan, Maria P. [6 ]
Sosa, Julia [6 ]
Gonzalez Lucero, Luciana [7 ]
Barbaglia, Ana L. [7 ]
Maldonado Ficco, Hernan [8 ]
Citera, Gustavo [1 ]
机构
[1] Inst Rehabil Psicofis, Sect Rheumatol, Buenos Aires, Argentina
[2] Hosp Interzonal Gen Agudos Petrona V de Cordero, Sect Rheumatol, San Fernando, Argentina
[3] Hosp Gen Agudos Dr Cosme Argerich, Sect Rheumatol, Buenos Aires, Argentina
[4] Inst Asistencia Reumatol Integral, Buenos Aires, DF, Argentina
[5] Hosp Clin Nicolas Avellaneda, Sect Rheumatol, San Miguel De Tucuman, Argentina
[6] Hosp Gen Agudos Dr Enrique Tornu, Sect Rheumatol, Buenos Aires, DF, Argentina
[7] Hosp Angel C Padilla, Sect Rheumatol, San Miguel De Tucuman, Argentina
[8] Hosp San Antonio Padua, Sect Rheumatol, Cordoba, Argentina
关键词
depression; functional capacity; quality of life; rheumatoid arthritis; PATIENT HEALTH QUESTIONNAIRE; DISEASE-ACTIVITY; DISABILITY; PREVALENCE; VALIDATION; ANXIETY; ARGENTINA; SYMPTOMS; COHORT; RISK;
D O I
10.1097/RHU.0000000000001506
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: The aim of this study was to determine the prevalence of depression among rheumatoid arthritis (RA) Argentinean patients and its association with sociodemographic and clinical factors. Methods: We performed a cross-sectional study of consecutive adults with RA. Sociodemographic data, comorbidities, RA disease activity, and current treatment were assessed. The following instruments were used to evaluate quality of life (EQ-5D-3 L [EURO Quality 5-dimension 3 lines], QOL-RA [Quality of Life-Rheumatoid Arthritis]), functional capacity (HAQ-A [Health Assessment Questionnaire-Argentinean version]), and depression (PHQ-9 [Patient Health Questionnaire 9]; scores 5-9: mild, 10-14: moderate, 15-19: moderate-severe, and >= 20: severe depression, a cutoff value >= 10 is diagnostic of major depression). Results: Two hundred fifty-eight patients were included, with a median disease duration of 9 years (interquartile range, 3.6-16.7 years). The m PHQ-9 score was 6 (interquartile range, 2-12.3 years). The prevalence of major depression was 33.8%. The frequency of mild, moderate, moderate/severe, and severe depression was 66 (25.6%), 42 (16.3%), 27 (10.5%), and 18 (7%), respectively. Patients with major depression had worse functional capacity (HAQ-A: mean +/- SD, 1.6 +/- 0.8 vs. 0.7 +/- 0.7; p < 0.0001), poorer quality of life (QOL-RA: mean +/- SD, 5.4 +/- 1.8 vs. 7.3 +/- 1.6; p < 0.0001), greater pain (visual analog scale: mean +/- SD, 56.2 +/- 27.5 mm vs. 33.4 +/- 25.7 mm; p < 0.0001), higher disease activity (Disease Activity Score in 28 joints: mean +/- SD, 4.3 +/- 1.4 vs. 3.3 +/- 1.3; p < 0.0001), higher frequency of comorbidities (67% vs. 33%; p = 0.017), and lower frequency of physical activity (22% vs. 35%; p = 0.032). In the multivariate analysis, patients with moderate and severe depression had worse functional capacity (odds ratio, 2.1; 95% confidence interval, 1.6-4.3; p < 0.0001) and quality of life (odds ratio, 0.7; 95% confidence interval, 0.5-0.8; p < 0.0001), independently of disease activity. Conclusions: A third of RA patients in this Argentinean cohort had major depression. In those patients, depression was associated with worst functional capacity and quality of life.
引用
收藏
页码:S180 / S185
页数:6
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