Hatice BODUR, Ayşegül KILIÇARSLAN, Yeşim Garip ÇİMEN, Aslı ÇALIŞKAN UÇKUN, Fatma GÜL YURDAKUL

Romatoid Artritte Depresyon: Yaşam Kalitesi, Fonksiyon ve Hastalık Aktivitesi ile İlişkisi

Amaç: Çalışmamızın amacı romatoid artritli (RA) hastalarda ağrı, hastalık aktivitesi, fonksiyonel durum ve vitalite, fonksiyonellik, sosyal ve duygusal işlevsellik gibi sağlıkla ilişkili yaşam kalitesi (HRQoL) alanları arasındaki ilişkiyi değerlendirmektir. Materyal ve Metot: Çalışmaya toplam 90 RA hastası ve 50 cinsiyet ve yaş uyumlu kontrol dahil edildi. Demografik özellikler, eritrosit sedimantasyon oranları, C‐reaktif protein, hassas ve şiş eklem sayısı, hasta ve hekimin global değerlendirmesi kaydedildi. Hastalık aktivitesini ölçmek için Hastalık Aktivite Skoru‐28 (DAS28) kullanıldı. Ağrının şiddeti, 10 cm Görsel Analog Skala‐Ağrı (VAS‐ağrı) kullanılarak belirlendi. HRQoL, Kısa Form 36 (SF 36) kullanılarak değerlendirildi. Fonksiyonel durumun değerlendirilmesi için HAQ (Sağlık Değerlendirme Anketi) kullanıldı. Depresyon, Beck Depresyon Ölçeği (BDS) kullanılarak değerlendirildi. Bulgular: Yaş ortalaması RA'da (54 kadın, 15 erkek) 54,51 ± 12,54; kontrol grubunda (41 kadın, 9 erkek) 51,94 ± 9,69 idi. RA'lı hastalarda ortalama VAS 55,85 ± 26,24 idi; HAQ 1,27 ± 0,81, DAS28 ise 5,04 ± 2,44 idi. RA grubunda ortalama BDS 19,67 ± 13,11 ve kontrol grubunda 6,64 ± 6,73 idi. RA hastalar kontrol grubu ile karşılaştırıldığında, BDS'de anlamlı olarak daha yüksek puan aldı (p

Depression in Rheumatoid Arthritis: Association with Quality of Life, Function and Disease Activity

Objectives: The aim of our study is to evaluate the depression rate in patients with rheumatoid arthritis(RA) and its association with pain, disease activity, functional status, and various health related qualityof life (HRQoL) domains in terms of functional status, vitality, social and emotional functioning.Materials and Methods: A total of 90 RA patients and 50 sex and age matched controls were includedin the study. Demographic characteristics, erythrocyte sedimentation rates, C‐reactive protein, tenderand swollen joint count, patient and physician global assessment of disease activity were recorded.Disease Activity Score‐28 (DAS28) was used for measuring disease activity. The severity of pain wasdetermined by using 10 cm Visual Analog Scale‐Pain (VAS‐pain). HRQoL was evaluated by using ShortForm 36 (SF 36).HAQ (Health Assessment Questionnaire) was used for evaluation of the functional status. Depressionwas evaluated by using Beck Depression Scale (BDS).Results: Mean age was 54.51±12.54 in RA (75 women, 15 men) group and 51.94±9.69 in the control group(41 women, 9 men). Mean VAS‐pain was 55.85±26.24; HAQ was 1.27±0.81 and DAS28 was 5.04 ±2.44 inRA patients. The mean BDS was 19.67±13.11 in RA group and 6.64±6.73 in the control group. RA patientsscored significantly higher in BDS when compared with the controls (p

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1. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12‐month DSM‐IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62:617‐27.
2. Walker JR, Lesley AG, Dutz JP, Bernstein CN. Psychiatric disorders in patients with immunemediated inflammatory diseases: prevalence, association with disease activity, and overall patient well‐being. J Rheumatol Suppl 2011;88:31‐5.
3. Scott DL, Wolfe F, Huizinga TW. Rheumatoid arthritis. Lancet 2010;376:1094‐108.
4. Strand V, Khanna D. The impact of rheumatoid arthritis and treatment on patients' lives. Clin Exp Rheumatol 2010;28:32‐40.
5. Aletaha D, Neogi T, Silman AJ et al. Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 2010;62:2569‐81.
6. Prevoo MLL, van't Hof MA, Kuper HH, et al. Modified disease activity scores that include twenty‐eight‐joint counts. Arthritis Rheum 1995;38:44‐8.
7. Price DD, McGrath P, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 1983;17:45‐56.
8. Ware JE Jr, Sherbourne CD. The MOS 36‐item short‐form health survey (SF‐36). I. Conceptual framework and item selection. Med Care 1992;30:473‐83.
9. Küçükdeveci AA, Sahin H, Ataman S, Griffiths B, Tennant A. Issues in Cross‐ Cultural Validity: Example from the adaptation, reliability, and validity testing of a Turkish version of the Stanford Health Assessment Questionnaire. Arthritis and Rheumatism 2004;51:14‐9.
10. Hisli N. Beck Depresyon Envanterinin Üniversite Öğrencileri için Geçerliliği ve Güvenirliği. Psikoloji Dergisi 1989;7:3‐13.
11. Pignone MP, Gaynes BN, Rushton JL et al. Screening for depression in adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2002;36:765‐76.
12. Iverson GL. Screening for depression in systemic lupus erythematosus with the British Columbia Major Depression Inventory. Psychol Rep 2002;90:1091‐6.
13. Thombs BD, Hudson M, Taillefer SS, Baron M. Canadian Scleroderma Research Group Prevalence and clinical correlates of symptoms of depression in patients with systemic sclerosis. Arthritis Rheum 2008;59:504‐9.
14. Nicassio PM. The problem of detecting and managing depression in the rheumatology clinic. Arthritis Rheum 2008;59:155‐8.
15. Matcham F, Rayner L, Steer S, Hotopf M. The prevalence of depression in rheumatoid arthritis: a systematic review and meta‐analysis. Rheumatology (Oxford) 2013;52:2136‐48.
16. Pu D, Luo J, Ju B, Lv X, Fan P, He L. Prevalence of depression and anxiety in rheumatoid arthritis patients and their associations with serum vitamin D level. Clin Rheumatol 2018;37:179‐ 84.
17. Fu Xin, Li Z, Yang C et al. The prevalence of depression in rheumatoid arthritis in China: A systematic review. Oncotarget 2017;8:53623‐30.
18. Masood A, Salim B, Nasim A, Khalid Z, Afzal A. Are we missing the diagnosis of depression in patients with rheumatoid arthritis at a tertiary care facility? Pak J Med Sci 2017;33:300‐5.
19. Jamshidi AR, Banihashemi AT, Paragomi P, Hasanzadeh M, Barghamdi M, Ghoroghi S. Anxiety and depression in rheumatoid arthritis: an epidemiologic survey and investigation of clinical correlates in Iranian population. Rheumatol Int 2016;36:1119‐25.
20. Yılmaz V, Umay E, Gündoğdu İ, Karaahmet ZÖ, Öztürk AE. Rheumatoid arthritis: Are psychological factors effective in disease flare? Eur J Rheumatol. 2017;4:127‐32.
21. Imran MY, Saira Khan EA, Ahmad NM, Farman Raja S, Saeed MA, Ijaz Haider I. Depression in Rheumatoid Arthritis and its relation to disease activity. Pak J Med Sci. 2015;31:393‐7.
22. Matcham F, Ali S, Irving K, Hotopf M, Chalder T. Are depression and anxiety associated with disease activity in rheumatoid arthritis? A prospective study. BMC Musculoskelet Disord 2016;1:155.
23. Magni G, Moreschi C, Rigatti Luchini S, Merskey H. Prospective study on the relationship between depressive symptoms and chronic musculo‐skeletal pain. Pain 1994;56:289‐97.
24. Linton SJ, Shaw WS. Impact of psychological factors in the experience of pain. Physical Ther 2011;91:700‐11.
25. Rezaei F, Doost HTN, Molavi H, Abedi MR, Karmifar M. Depression and pain in patients with rheumatoid arthritis: Mediating role of illness perception. The Egyptian Rheumatologist 2014; 36:57‐64.
26. Ulus Y, Tander B, Akyol Y et al. Are Illness Perceptions Associated With Disease Activity or Psychological Well‐Being in Rheumatoid Arthritis? A Study With the Evidence of Confirmatory Factor Analysis. Arch Rheumatol 2017;32:315‐24.
27. Ozcetin A, Ataoglu S, Kocer E, et al. Effects of depression and anxiety on quality of life of patients with rheumatoid arthritis, knee osteoarthritis and fibromyalgia syndrome. West Indian Med J 2007;56:122–9.
28. Nichol MB, Lihua Z. Depression and health‐related quality of life in patients with rheumatoid arthritis, Expert Review of Pharmacoeconomics & Outcomes Research 2014;5:645‐53.