The prevalence of depression/anxiety in patients with rheumatoid arthritis and the correlation with quality of life

Abstract

Introduction. Rheumatoid arthritis (RA) is accompanied by numerous comorbidities, among which depression and anxiety (D/A) occupy a significant place. Objective. To assess the prevalence of D/A in RA patients and their correlation with quality of life. Methods. The study included RA patients treated at the Rheumatology Clinic of the Military Medical Academy in the period from May to November 2016. Disease activity was assessed by the Disease Activity Score 28-SE (DAS28-SE). Depression/anxiety was determined using the Hospital Anxiety and Depression Scale (HADS Questionnaire) and EuroQoL Five-Dimensional Questionnaire (EQ5D3L Questionnaire) Question 5. Three questionnaires were used to assess quality of life: the general RAND36 (The RAND 36-item Health Survey 1.0) and the specific RAQL and EQ5D3L. Results. On the basis of the HADS Questionnaire, the prevalence of depression was 52% with the average HADS score value of 7.6?3.2, while the prevalence of anxiety was 32% with the mean HADS score value of 5.8?3.8. Question 5 of the EQ5D Questionnaire showed that the prevalence of D/A was 77.4%, of which 71.7% of patients had moderate D/A, while 5.7% of patients had severe D/A. Impairment in all the domains of quality of life was found in some patients, as assessed by all the three questionnaires. The RAQL Questionnaire showed moderate quality of life impairment, with the value of 15.5?7.9. The EQ-VAS value was 58.6?16.0, while the EQ5D index was 0.6?0.3. Univariate linear regression produced a statistically significant negative predictive value of quality of life for the presence of anxiety/depression. Multivariate linear regression showed a statistically significant independent negative predictive value of quality of life, as assessed by the RAQL Questionnaire (p=0.010) and the mental quality of life component of the RAND 36 Questionnaire (p=0.030) for the degree of depression. Conclusion. In RA patients, there is significant prevalence of D/A as well as impairment of quality of life in all domains. The tests performed have shown that quality of life has a statistically significant negative predictive value for the presence of D/A.