THU0589 Correlation of Depression with Patient Global Assessment, Sleep Disturbance and Health Status in Patients with Rheumatoid Arthritis
Authors: K. Yukioka, H. Nakahara, M. Fusama, T. Kuroiwa, N. Takai, C. Yukioka, N. Murata, M. Inoue, T. Nakanishi, K. Higashi, T. Kuritani, K. Maeda, Y. Miura, H. Sano, M. Yukioka
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Depression is common in rheumatoid arthritis (RA). The influences of depression on disease activity, self-efficacy and health status are not well assessed in patients with RA. <h3>Objectives</h3> To assess the correlation of depression with disease activity including patient global assessment (PGA), self-efficacy, sleep disturbance and Quality of life (QOL) in patients with RA. <h3>Methods</h3> Patients with RA were enrolled from Yukioka Hospital and NTT West Osaka Hospital in Japan. The patients were divided to depression group (CES-D 16≤) and non-depression group (CES-D16&gt;) according to the Center for Epidemiological Studies Depression (CES-D) scale. Swollen joint count (SJC), tender joint count (TJC), evaluator global assessment (EGA), PGA and clinical disease activity index (CDAI) were assessed. Anxiety was assessed utilizing State-Trait Anxiety Inventory (STAI) and Hospital Anxiety and Depression Scale-Anxiety (HADS-A), while self-efficacy with General Self-Efficacy Scale (GSES), sleep disturbance with Pittsburgh Sleep Quality Index (PSQI) and QOL with Sort Form-36 (SF-36). The data was analyzed using Wilcoxon signed-rank test. <h3>Results</h3> One hundred twelve patients (18 males and 94female) were assessed. Baseline characteristics were as follows: median [range] of age (55.5, [26-83] years old), duration (8.59, [0.25-48] years), SJC (1, [0-25]), TJC (1, [0-17]), PGA (19, [0-84]), EGA (14, [0-88]) and CDAI (6.85, [0-54.2]), respectively. There was no significant difference in age, duration and dosage of prednisolone between depression group (n=28) and non-depression group (n=84) (p=0.4761, p=0.7829, p=0.4161, respectively). There was no significant difference in SJC, TJC and EGA between 2 groups (p=0.1651, p=0.0983, p=0.0601, respectively). However, PGA and CDAI were significantly lower in non-depression group (p&lt;0.005 and p=0.0417, respectively). Similarly, STAI (state anxiety) was significantly lower non-depression group (p&lt;0.0001). The rate of patients with anxiety assessed with HADS-A was significantly lower in non-depression group (p&lt;0.0001), while GSES was significantly higher in non-depression group (p&lt;0.05). The rate of patients with sleep disturbance assessed with PSQI was significantly lower in non-depression group (p&lt;0.0001). In SF-36, there was no significant difference in physical component summary (PCS) between 2 groups (p=0.2101), while mental component summary (MCS) was significantly higher in non-depression group (p&lt;0.0001). <h3>Conclusions</h3> These data suggests that depression have undesirable influences on PGA, self-efficacy, sleep disturbance and mental phase of QOL in patients with RA. This study provides that supports for depressive state might be effective for improvement of PGA, self-efficacy, sleep disturbance and QOL in patients with RA. <h3>Disclosure of Interest</h3> None Declared