POS1494-HPR INCIDENCE OF PSYCHIATRIC DISORDERS AND FIBROMYALGIA IN PATIENTS WITH RHEUMATOID ARTHRITIS AND PSORIATIC ARTHRITIS DURING COVID 19 PANDEMIC: THE ROLE OF TELEMEDICINE.

Abstract

BackgroundThe management of patients with immuno-rheumatological diseases has profoundly changed during the COVID 19 pandemic and telemedicine has played an important role in the disease follow-up.In addition to monitoring disease activity and any adverse events, especially infectious events, assessing the psychological situation of the patient can be fundamental in particular considering that COVID-19 has also a serious impact on mental health and it has been demonstrated a significantly higher incidence of anxiety disorders and depressive symptoms especially in younger peopleObjectivesThe aim of this study is to evaluate the incidence of depressive disorders, anxiety and fibromyalgia in our patients with rheumatoid arthritis and psoriatic arthritis during the lockdown period due to the COVID 19 pandemic and validate the use of telemedicine in the clinical management of these patients.MethodsPatients affected by rheumatoid and psoriatic arthritis treated with biological disease-modifying drugs were contacted to evaluate the state of health and the presence of any adverse events and a nurse administered the clinimetric questionnaires assessment to evaluate the disease activity, the impact of rheumatic disease on the health status and the presence of anxiety, depression and fibromyalgia. In particular the following scales have been used: The Rheumatoid Arthritis Impact of Disease (RAID), the Psoriatic arthritis impact of disease (PsAID), Beck Depression Inventory BDI-II, State-Trait Anxiety Inventory (STAI) and The Fibromyalgia Rapid Screening Tool questionnaire (FIRST), The VAS scale for the assessment of pain. Patients who reported disease flare-up or adverse events underwent an outpatient visit and during visit Disease Activity Score (DAS 28) and Disease Activity Index for Psoriatic Arthritis (DAPSA) were used.Results171 patients with rheumatoid arthritis (RA) and 129 patients with psoriatic arthritis were enrolled. The incidence of fibromyalgia was increased in the two groups during the lockdown compared to the previous evaluations and in particular in patients with psoriatic arthritis (AR p =0.013, AP p= 0.001).Our analysis did not report significant differences between the two groups for the presence of fibromyalgia and anxiety-related disorders during lockdown, but a prevalence of depressive disorders in patients with rheumatoid arthritis was observed.During lockdown in RA patients, (n=50), no correlation was found between DAS28 and RAID score (r=0.112, p=0.438) and in PsA patients (n=34), no correlation was found between DAPSA and PSAID score (r=0.131, p=0.459) while median value of RAID was higher in STAI I and II positive and median value of PSAID was higher in STAI I and II positive. Patients positive at BDI had higher RAID score (median 6.28 vs 1.14) and PSAID (median 4.95 vs 2.85) score (Mann Whitney p<0.001 and p=0.003)ConclusionIn conclusion, mental and physical stress during COVID-19 pandemic can greatly worsen FM symptoms and intensify the patients’ suffering without a clinical flare of the inflammatory disease for patients affected by rheumatoid arthritis.Telemedicine has allowed us to identify patients who needed a face-to-face approach for therapeutic reevaluation even if not related to a flare of the disease.References[1]Coletto LA DermatolTher. 2020 Apr 14:e13415. doi: 10.1111/dth.13415.[2]Lurie N JAMA Intern Med 2018;178:745–6[3]Matteo Piga Seminars in Arthritis and Rheumatism 47 (2017) 121–128123Disclosure of InterestsNone declared