Background/Purpose: Both rheumatoid (RA) and psoriatic arthritis (PsA) seem to have a negative impact on patients’ psychological status mostly due to the chronic character of the disease. Literature reports and clinical practice evidence support that patients suffering from PsA express their discomfort and complaints more often than those who suffer from RA, even when the physical disability is similar between them. The aim of the study is to compare aspects of the psychological profile of the two groups of patients and to examine the differences between their behavior

Methods: The study sample consisted of 59 outpatients of the 4^th Medical Department of Internal Medicine of Aristotle University of Thessaloniki, suffering from RA and PsA. Disease activity was measured using DAS28 score. Psychological characteristics were evaluated with the use of SCL-90-R questionnaire while other information including quality of life (QoL), general health (GH) and disability were assessed with the use of SF-36, GHQ and HAQ-DI. Patients suffering from extended psoriatic skin lesions (BSA>5) as well as those who presented axial joint damage were excluded in order to ensure clinical similarity between the two groups of patients.

Results: A total of 32 patients suffering from RA and 27 from PsA were recruited. Mean age for RA group was 48.2 (±10.6) and PsA 49.3 (±7.6) years. No significant difference in DAS (p=0.843), disability (p=0.466), GH (p=0.801) and VAS score (p=0.855) was found between the two groups. As far as QoL is concerned, the two groups did not demonstrate difference in any of the subscales of SF-36. Patients with RA demonstrated lower scores in Interpersonal Sensitivity (Subscale III of SCL-90-R) (p=0.044) than those with PsA.

In the RA group, DAS was found to correlate with disability (r=0.804, p=0.000), GH (r=0.519 p=0.002), Somatization (I) (r=0.440 p=0.012) and Depression (IV) (r=0.426 p=0.015). Only the physical component (PCS) of the SF-36 correlates with the DAS28 score (r=-0.741 p=0.000). Both disability and GH correlate with I and IV (r= 0.604 p=0.000) (r=0.536 p=0.002) (r=0.416 p=0.018) (r=0.431 p=0.014) respectively.

In the PsA group DAS28 score does not correlate with GH (p=0.702) or IV (p=0.123) but it does correlate with HAQ score (r=0.491 p=0.009), I (r=0.312 p=0.033) and PCS (r=-0.606 p=0.001). HAQ score correlates with IV (r=0.559 p=0.002) as well as the PCS (r=0.812 p=0.000). GH correlates with most of the subscales of SCL-90-R except for the III (p=0.054) while there is no correlation with the PCS (p=0.275) contrary to the Mental Component (MCS) (r=-0.476 p=0.012). Finally the III subscale of SCL-90-R does not correlate with any of the measured clinical parameters.

Conclusion: In consistence with findings from everyday interaction during clinical evaluation, PsA patients rather than RA ones seem to meet with feelings of self- deprivation, uneasiness, discomfort during interpersonal interaction, personal inadequacy and inferiority in comparison with others. Moreover, the differences in psychological characteristics between patients with RA and PsA cannot be attributed to the degree of skin lesion, disease activity or disability.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/differences-in-psychological-characteristics-between-patients-with-rheumatoid-and-psoriatic-arthritis/