Concurrent psychiatric disorders are associated with significantly poorer quality of life in patients with rheumatoid arthritis

C C Mok, E Y C Lok, E F C Cheung
Scandinavian Journal of Rheumatology 2012, 41 (4): 253-9

OBJECTIVES: To study the effect of concurrent psychiatric disorders on health-related quality of life (HRQOL) in patients with rheumatoid arthritis (RA).

METHODS: Consecutive Chinese patients who fulfilled the American College of Rheumatology (ACR) criteria for RA were recruited and interviewed by a psychiatrist for psychiatric disorders using the Chinese Bilingual Structured Clinical Interview for DSM-IV Axis I Disorders, Patient version (CB-SCID-I/P). HRQOL was assessed by the validated Chinese version of the 36-item Short Form Health Survey (SF-36). Sociodemographic and clinical data were also collected. Fatigue was assessed by the Functional Assessment of Chronic Illness Therapy - Fatigue scale (FACIT-F).

RESULTS: Two hundred patients with RA were studied (79% women, mean age 51.4 ± 10.5 years; median RA duration 4.0 years). Forty-seven (23.5%) patients were diagnosed with a psychiatric disorder: depressive disorders in 29 patients and anxiety disorders in 26 patients. Patients with either condition had significantly higher fatigue scores (26 ± 8.8 vs. 16 ± 6.9, p < 0.001) and were more likely to be unemployed (p = 0.02) and dependent on government subsidy for living (p < 0.001) than those without. The scores of the eight domains and the physical and mental components of the SF-36 were significantly lower in RA patients with psychiatric disorders (p < 0.001 in all). In a linear regression model, the presence of either depressive or anxiety disorders (β = -0.23, p < 0.001), older age (β = -0.16, p = 0.006), self-perceived pain (β = -0.25, p < 0.001) and fatigue (β = -0.42, p < 0.001) were independently and inversely associated with the total SF-36 score after adjustment for disease activity and other sociodemographic variables.

CONCLUSIONS: Concomitant depressive or anxiety disorders in RA patients are associated with significantly poorer HRQOL. Early identification and treatment of psychiatric disorders in RA patients are warranted.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"