AB0864-HPR INFLUENCE OF THE TYPE OF PAIN SYNDROME ON THE SEVERITY OF ANXIETY-DEPRESSIVE DISORDERS IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: E. Egorova, N. Nikitina, A. Rebrov
Journal: Annals of the Rheumatic Diseases (2021)

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease that leads to joint damage and deformation. Pain syndrome, along with functional limitations, causes the emergence of anxiety-depressive disorders. The patient’s psycho-emotional characteristics affect the patient’s quality of life and the effectiveness of the therapy. The aim: to assess the severity of anxiety and depression in women with rheumatoid arthritis, depending on the type of the pain syndrome. Objectives: The study included 163 women with RA according to the EULAR / ACR 2010 criteria (age 53,9 ± 10,15 years, RA duration - 10 [4; 14] years, DAS28 – 5,03 [4,35; 5,8]). Methods: We used the Hospital Depression and Anxiety Scale (HADS) questionnaire: 0-7 points were assessed as the absence of significant symptoms of anxiety and depression, 8-10 points - subclinically expressed anxiety and depression, more than 11 points - clinically expressed anxiety and depression. The severity of pain was determined by the VAS: no pain (0-4 mm), mild pain (5-44 mm), moderate pain (45-74 mm), severe pain (75-100 mm). Assessment of the type of pain (identification of the neuropathic component of pain) was carried out using the DN4 questionnaire: a sum of 4 or more points indicated the presence of a neuropathic component of pain (NCP). Statistical processing was performed using the STATISTICA 10,0 program. Results: The frequency of occurrence of anxiety-depressive disorders in RA patients was determined: clinically pronounced anxiety was detected in 35 (21,4%) patients, depression - in 34 (20,9%); subclinically expressed anxiety - in 42 (25,8%), depression - in 44 (27%) patients; absence of reliably pronounced symptoms of anxiety - in 86 (52,8%) patients, depression - in 85 (52,1%) patients. Severe pain according to VAS was noted in 57 (35%) patients, moderate pain - in 75 (46%), in 31 (19%) patients the pain syndrome was mild. In 81 (49,7%) patients a neuropathic component of pain was revealed. The relationship was established between the presence of NCP and the severity of anxiety (r = 0,27, p &lt; 0,05), depression (r = 0,31, p &lt;0,05). The relationship was revealed between the presence of NCP and the severity of pain according to the VAS (r = 0.32, p &lt;0.05). To explain the relationship between the presence of NCP and anxiety-depressive disorders, the patients were divided into two groups depending on the presence of NCP, comparable in age, the main clinical characteristics of RA, and basic therapy. The level of anxiety in women with NCP (9,5 [7; 13]) was significantly higher than in patients without NCP (6.1 [4; 9]) (p = 0.01). The severity of depression in women with NCP was 8,55 [6; 11], in patients without NCP – 5,15 [3; 6] (p = 0.005). Conclusion: Thus, every fifth patient with RA had clinically significance anxiety and depression, subclinical anxiety and depression were found in 26% of RA patients. Most of the patients (81%) had moderate or severe pain, half of the patients had signs of neuropathic pain. The relationship between the severity of anxiety and depression with the intensity of pain and the presence of a neuropathic component was revealed. Disclosure of Interests: None declared