ASSOCIATION BETWEEN ANXIETY-DEPRESSIVE SPECTRUM DISORDERS AND JOINT DISEASE IN WOMEN
https://doi.org/10.14412/1995-4484-2017-641-646
Abstract
The frequency of anxiety-depressive spectrum disorders (ADSDs) in patients with rheumatic diseases (RDs) is much higher than that in the general population. ADSDs are known to be associated with pain intensity, disease activity, and functional limitations. However, the majority of available papers are limited by the framework of a certain disease. Objective: to investigate the association of ADSDs with the characteristics of joint damage beyond the nosological approach. Subjects and methods. The investigation enrolled 38 women aged 18 years and older who had different RDs and preserved reproductive function, were treated at round-the-clock hospitals, and had no clinically significant comorbid diseases. All the patients were divided into two subgroups: 1) those with predominant hand joint injury and 2) those with joint involvement at other sites. All the patients were evaluated for disease activity (DAS-28-ESR, ASDAS-ESR), pain (visual analogue scale), and functional status (HAQ). The Hospital Anxiety and Depression Scale (HADS) was used to detect ADSDs and the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Depression Rating Scale were employed to rate the severity of anxiety and depression, respectively. Results and discussion. The frequency of anxiety disorders evaluated through the HADS and the HAM-A was 44.7 and 34.2%, that of depressions was 34.2 and 60.5% respectively. The clinically evident level of HADS anxiety (11+) in Subgroup 1 was detected 5 times more frequently (30.0%) than in Subgroup 2 (5.5%); and that of HAM-A anxiety (18+) was twice as often: 45.0 and 22.2%, respectively. The frequency of clinically significant depression according to HADS (11+) and HAM-D (14+) in Subgroup 1 was 30.0 and 40.0%, and that in Group 2 was 11.1 and 16.7% respectively. The probability of severe depressions (HAM-D 19+) in hand joint injury was twice higher (odds ratio, 2.2; 95% confidence interval, 1.51–3.19) than in arthritis at various sites. Thus, this investigation provides evidence for the high frequency of ADSDS in patients with RDs. Reproductive-aged women with hand joint injury are one of the most vulnerable groups.
About the Authors
A. O. VasilyevaRussian Federation
P. A. Shesternya
Russian Federation
M. M. Petrova
Russian Federation
References
1. Bulletin of the World Health Organization 2017;95:244-5. Электронный ресурс [http://www.who.int/bulletin/volumes/95/4/17-010417.pdf?ua=1] Ссылка доступна на 21.09.2017.
2. Chisholm D, Sweeny K, Sheehan P, et al. Scaling-up treatment of depression and anxiety: a global return on investment analysis. Lancet Psych. 2016;3(5):415-24. doi: 10.1016/S2215-0366(16)30024-4
3. Baxter AJ, Scott KM, Vos T, et al. Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychol Med. 2013;43:897-910. doi: 10.1017/S003329171200147X
4. Ferrari AJ, Somerville AJ, Baxter AJ, et al. Global variation in the prevalence and incidence of major depressive disorder: a systematic review of the epidemiological literature. Psychol Med. 2013;43:471-81. doi: 10.1017/S0033291712001511
5. Шальнова СА, Евстифеева СЕ, Деев АД и др. Распространенность тревоги и депрессии в различных регионах Российской Федерации и ее ассоциации
6. с социально-демографическими факторами (по данным исследования ЭССЕ-РФ). Терапевтический архив. 2014;(12):52-9 [Shal'nova SA, Evstifeeva SE, Deev AD, et al. The prevalence of anxiety and depression in various regions of the Russian Federation and its association with socio-demographic factors (according to the ESSE-RF study). Terapevticheskii Arkhiv. 2014;(12):52-9 (In Russ.)].
7. Оганов РГ, Ольбинская ЛИ, Смулевич АБ и др. Депрессии
8. и расстройства депрессивного спектра в общемедицинской практике. Результаты программы КОМПАС. Кардиология. 2004;(1):48-54 [Oganov RG, Ol'binskaya LI, Smulevich AB, et al. Depression and depressive disorder in general medical practice. The results of the COMPASS program. Kardiologiya. 2004;(1):48-54 (In Russ.)].
9. Балабина НМ. Проблема тревожных расстройств в практике участкового терапевта. Сибирский медицинский журнал. 2010;94(3):111-2 [Balabina NM. The problem of anxiety disorders in the practice of the local therapist. Sibirskii Meditsinskii Zhurnal. 2010;94(3):111-2 (In Russ.)].
10. Ахмадеева ЛР, Терегулова ДР. Тревожные и депрессивные состояния и их связь с болевым синдромом у пациентов, находящихся на стационарном лечении. Проблемы женского здоровья. 2012;7(2):23-8 [Akhmadeeva LR, Teregulova DR. Alarming and depressive conditions and their relation to pain syndrome in patients undergoing inpatient treatment. Problemy Zhenskogo Zdorov'ya. 2012;7(2):23-8 (In Russ.)].
11. Лисицына ТА, Вельтищев ДЮ, Насонов ЕЛ. Стрессовые факторы и депрессивные расстройства при ревматических заболеваниях. Научно-практическая ревматология. 2013;51(2):98-103 [Lisitsyna TA, Veltishchev DYu, Nasonov EL. Stressors and depressive disorders in rheumatic diseases. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2013;51(2):98-103. (In Russ.)]. doi: 10.14412/1995-4484-2013-634
12. Margaretten M, Julian L, Katz P, et al. Depression in patients with rheumatoid arthritis: description, causes and mechanisms. Int J Clin Rheumtol. 2011;6(6):617-23. doi: 10.2217/ijr.11.62
13. Лисицына ТА, Вельтищев ДЮ, Герасимов АН и др. Факторы, влияющие на восприятие боли при ревматоидном артрите. Клиническая медицина. 2013;91(3):54-61 [Lisitsyna TA, Vel'tishchev DYu, Gerasimov AN, et al. Factors affecting the perception of pain in rheumatoid arthritis. Klinicheskaya Meditsina. 2013;91(3):54-61 (In Russ.)].
14. Лисицына ТА, Вельтищев ДЮ, Краснов ВН и др. Клинико-патогенетические взаимосвязи иммуновоспалительных ревматических заболеваний и психических расстройств. Клиническая медицина. 2014;92(1):12-20 [Lisitsyna TA, Vel'tishchev DYu, Krasnov VN, et al. Clinico-pathogenetic relationships of immuno-inflammatory rheumatic diseases and psychiatric disorders. Klinicheskaya Meditsina. 2014;92(1):12-20
15. (In Russ.)].
16. Насонов ЕЛ, редактор. Российские клинические рекомендации. Ревматология. Москва: ГЭОТАР-Медиа; 2017. 464 с. [Nasonov EL, editor. Rossiiskie klinicheskie rekomendatsii. Revmatologiya [Russian clinical guidelines. Rheumatology]. Moscow: GEOTAR-Media; 2017. 464 p.].
17. Michelsen B, Kristianslund EK, Sexton J, et al. Do depression and anxiety reduce the likelihood of remission in rheumatoid arthritis and psoriatic arthritis? Data from the prospective multi-center NOR-DMARD study. Ann Rheum Dis. Pub. Online First: 21 July 2017. doi: 10.1136/annrheumdis-2017-211284
18. Коршунов НИ, Курыгин АГ, Речкина ЕВ и др. Ревматоидный артрит как психосоматическое заболевание. Научно-практическая ревматология. 2015;53(5):469-71 [Korshunov NI, Kurygin AG, Rechkina EV, et al. Rheumatoid arthritis as a psychosomatic disease. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2015;53(5):469-71 (In Russ.)]. doi: 10.14412/1995-4484-2015-469-471
19. Амирджанова ВН. Шкалы боли и HAQ в оценке пациента
20. с ревматоидным артритом. Научно-практическая ревматология. 2006;44(2):60-5 [Amirjanova VN. Pain scales and HAQ in assessing a patient with rheumatoid arthritis. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2006;44(2):60-5 (In Russ.)].
21. Обухова ЛФ. Возрастная психология: учебник. Москва: Юрайт, МГППУ; 2011. 460 с. [Obukhova LF. Vozrastnaya psikhologiya: uchebnik [Age psychology: a textbook]. Moscow: Yurait, MGPPU; 2011. 460 p.].
22. Romera I, Perez V, Menchon JM. Optimal cutoff point of the Hamilton Rating Scale for Depression according to normal levels of social and occupational functioning. Psych Res. 2011;186(1):133-7. doi: 10.1016/j.psychres.2010.06.023
Review
For citations:
Vasilyeva A.O., Shesternya P.A., Petrova M.M. ASSOCIATION BETWEEN ANXIETY-DEPRESSIVE SPECTRUM DISORDERS AND JOINT DISEASE IN WOMEN. Rheumatology Science and Practice. 2017;55(6):641-646. (In Russ.) https://doi.org/10.14412/1995-4484-2017-641-646