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Depression and anxiety in a real-world psoriatic arthritis longitudinal study: should we focus more on patients’ perception?
C.G. Gialouri1, G. Evangelatos2, S.S. Zhao3, K. Kouna4, A. Karamanakos5, A. Iliopoulos6, M.G. Tektonidou7, P.P. Sfikakis8, G.E. Fragoulis9
- Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Greece.
- Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Greece.
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
- Rheumatology Department, 417 Army Shared Fund Hospital NIMTS, Athens, Greece.
- Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Greece.
- Rheumatology Department, 417 Army Shared Fund Hospital NIMTS, Athens, Greece.
- Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Greece.
- Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Greece.
- Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Greece. geofragoul@yahoo.gr, george.fragkoulis@glasgow.ac.uk
CER15637
2023 Vol.41, N°1
PI 0159, PF 0165
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PMID: 35819812 [PubMed]
Received: 28/02/2022
Accepted : 02/05/2022
In Press: 08/07/2022
Published: 23/01/2023
Abstract
OBJECTIVES:
Longitudinal studies using validated tools to evaluate depression and anxiety in psoriatic arthritis (PsA) are lacking. We aimed to estimate their course in PsA and to examine possible associations with disease-related parameters and patient-reported outcomes (PROs).
METHODS:
PsA patients attending two outpatient rheumatology clinics were consecutively enrolled (January 2019-June 2021, n=128). The hospital anxiety and depression scale (HADS) was used at two sequential visits (mean±SD: 10±6 months) to prospectively assess depression (HADS-Depression) and anxiety (HADS-Anxiety) (cut-off scores ≥11). Associations with demographic, clinical, laboratory features and PROs for quality of life (QoL) (EQ-5D), functional status (HAQ-DI) and nocebo-behaviour (Q-No) were examined. ‘Change’ was the difference between values at the first and second visit.
RESULTS:
Prevalence of depression and anxiety at the first visit was 19.5% and 21.1%, respectively. Depression was associated with EQ-5D [OR (95% CI): 1.70 (1.02-2.59), p=0.019] and anxiety with EQ-5D [1.81 (1.20 to 2.72), p=0.005], nocebo-behaviour [1.19 (1.01-1.40), p=0.04] and current corticosteroid use [6.95 (1.75-27.59), p=0.006]. At the second visit, HADS-Depression and HADS-Anxiety scores were improved in 40.9% and 41.9% of patients, respectively. While no associations were found for HADS-Anxiety score change, changes in HADS-Depression score correlated with changes in subjective (tender joint count, r= 0.204, p=0.049; PtG, r= 0.236, p=0.023; patient pain assessment, r= 0.266, p=0.01) but not objective (swollen joint count, ESR, CRP) parameters of disease activity.
CONCLUSIONS:
In PsA, depression and anxiety are associated with worse PROs, including QoL. Subjective parameters of disease activity parallel course of depression.
