Background/Purpose: Pain, disability, and depression are present in various degrees in patients with Rheumatoid Arthritis (RA). In spite of meeting the same diagnostic criteria, some patients with RA report much less pain, disability, and little or no psychological distress than others. The current study seeks to ascertain potential subgroups of patients in a RA sample based on levels of pain, disability, and depression and to identify factors associated with patient clustering.
Methods: The sample included 100 patients with confirmed RA participated in an assessment of their disease activity, pain, depression during an evaluation prior to participating in a randomized controlled trial. Self-report measures included the Rapid Assessment of Disease Activity in Rheumatology (RADAR), the SF-36 social functioning Scale, the Helplessness and Internality Subscales of the Arthritis Helplessness Index (AHI), the Active and Passive Pain Coping Scales of the Pain Management Inventory (PMI), the Center for Epidemiological Studies Depression Scale (CES-D), the Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), and the Health Assessment Questionnaire (HAQ). Cluster analysis was used in this research to ascertain the existence of subgroups of patients in a Rheumatoid Arthritis sample based on these variables.
Results: Two clusters were defined: a low-functioning group characterized by high levels of pain, disability, and depression (n = 73) and a high-functioning group characterized by low levels of pain, disability, and depression (n = 27). Analysis of Variance (ANOVA) confirmed differences between clusters on these health status factors, except disability. A second series of ANOVAs revealed that the high-functioning subgroup had greater social functioning, better sleep quality, and less passive coping and perceived stress than the low-functioning group. Hierarchical multiple regressions indicated that the best discriminators of subgroup membership were sleep quality and perceived stress.
Conclusion: These results indicate significant heterogeneity in RA patients. The data also suggest that different approaches to patient management, particularly intervention strategies aimed at reducing perceived stress and improving sleep quality, may be beneficial for patients who are functioning poorly in the face of this condition.
Disclosure:
T. Draper,
None;
S. R. Ormseth,
None;
M. Custodio,
None;
M. H. Weisman,
None;
M. R. Irwin,
None;
P. M. Nicassio,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/identifying-subgroups-of-rheumatoid-arthritis-patients-based-on-levels-of-pain-disability-and-depression/