Session Type: Abstract Submissions (ACR)
Rheumatoid Arthritis (RA) can be associated with psychological disorders and especially depression. About 13 – 20 % of patients have clinical significant depression. It was shown (Dougados, 2014 COMORA Study) that depression in this group of patients has a high variability between countries (2 % Morocco – 33 % USA). However, it is still incompletely understood how RA could influence on perception of depression and its impact on quality of life in RA patients from different countries. The purpose of study was to characterise distribution of depression and its impact on pain and social status of patients with RA in different countries.
100 RA patients from Germany (age 62,4 ± 12,3 years) and 91 RA patients from Brazil (age 56,3 ± 12,6 years), mean duration of disease in Germany was 14,3 ± 10,4 years and in Brazil 15,9 ± 10,2 years, could be included in this study. RA was diagnosed according to the ACR/EULAR Criteria 2010 and the following questionnaires were utilised: Beck depression inventory (BDI), painDETECT test (Freynhagen R., et al., 2006), visual analogue scale for pain (VAS), SF – 36 and Health Assessment Questionnaire (HAQ-DI).
About 20% RA patients in Brazil were diagnosed with associated depression. Furthermore 27,4 % of Brazilian patients had a subclinical depression. It is significant higher compare to RA patients in Germany (only 10%; p = 0,039). There is no difference between pain intensity in two groups of patients (VAS 4,7 ± 3,4 mm (Brazil) vs 3,6 ± 2.3 (Germany). However 61,5 % of Brazilian patients showed symptoms of neuropathic pain compare to 48.3 % of patients from Germany (p = 0,001). There are a correlation between pain and depression in both groups (Brazil: r = 0,520, p < 0,001; Germany: r = 0,392, p < 0,001). Furthermore, a significant difference was detected in psychological scales of quality of life between both groups of patients (46,6 ± 12,3 Brazil compare to 51,4 ± 11,4 Germany; p = 0,002). Interestingly, there was no difference between the activity of disease (DAS 28) between two groups of patients (3,4 ± 1,5, Brazil vs 3,3 ± 1,3, Germany). However Brazilian patients had more erosions (X-ray) compare to Germans group of patients (p = 0,011). Moreover it was significant difference between methods of therapy in both groups of patients. Only 5 % Brazilian patients had biologics compare to about 30% RA patients in Germany. There are correlation between the functional status of patients and pain (HAQ and pain: r = 0,628, p < 0,001), as well as the functional status and depression (HAQ and BDI: r = 0,552, p < 0,01). Concerning family status, more Brazilian patients were single compare to Germans patients (p = 0,001). In Brazil there was found an higher number of patients with children compare with Germans group (74,2 %; p = 0,015).
The study indicates that RA-related depression could contribute to diminished psychological well-being in RA patients and suggests the need for psychoeducational and management strategies that specifically target depression as part of RA management program. Future research should attempt to obtain a larger sample of male and younger RA patients to determine if there are significant gender and age differences in the impact of depression on outcomes of RA in different countries.
G. da Rocha,
A. B. Vargas,
C. G. Baerwald,
« Back to 2014 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-depression-on-clinical-and-social-outcomes-in-patients-with-rheumatoid-arthritis-comparative-study-in-germany-and-brazil/