Rheumatoid arthritis and mental health: Czech clinical data
Authors:
M. Hušáková 1; K. Mladá 2; M. Olejárová 1; V. Balajková 1; J. Kotrs 3; M. Bednář 3; L. Šenolt 1; P. Mohr 2,4; K. Pavelka 1
Authors‘ workplace:
Revmatologická klinika 1. lékařské fakulty Univerzity Karlovy a Revmatologický ústav
1; Národní ústav duševního zdraví, Klecany
2; Health Monk, s. r. o.
3; 3. lékařská fakulta Univerzity Karlovy v Praze
4
Published in:
Čes. Revmatol., 32, 2024, No. 4, p. 140-151.
Category:
Original article
Overview
Introduction: Rheumatoid arthritis (RA) is associated with multiple comorbidities. Mental health disorders can exacerbate the impact of RA on patients’ lives. The aim of our study was to investigate the prevalence of psychiatric comorbidities and their effects on RA in a tertiary rheumatology center in the Czech Republic.
Methods: This is a cross-sectional study conducted at a tertiary center, including patients with RA with disease duration of 2–15 years, with a detailed characterization of disease activity (Disease Activity Score – DAS-28).
A control group of healthy individuals was also included. Mental health was assessed using the Mini International Neuropsychiatric Interview (M.I.N.I.), the Beck Depression Inventory (BDI-II), and the Beck Anxiety Inventory (BAI). Additional questionnaires evaluated quality of life (5DEQ), functional abilities (HAQ), and sociodemographic characteristics.
Results: RA patients significantly differed from controls in the presence of any psychiatric disorder (PD) in the M.I.N.I. modules (24.78% vs. 6.67%, p < 0.001), particularly major depressive episodes and suicidality. They also had a higher prevalence of depression (18.59% vs. 3.8%) and anxiety (38.93% vs. 13.08%; p < 0.0001 in both) based on self-reported questionnaires. RA patients with a positive M.I.N.I. screening had a moderate disease activity (DAS28 3.40 ± 1.39) compared to M.I.N.I.-negative patients (2.79 ± 1.07, p < 0.05). A similar pattern was observed in patients with concurrent depression and anxiety according to the Beck inventories. These individuals also had significantly lower quality of life (5DEQ 0.56 ± 0.25 vs. 0.76 ± 0.17, p < 0.01 and 0.59 ± 0.07 vs. 0.80 ± 0.11, p < 0.001) and worse functional abilities (HAQ 1.68 ± 0.96 vs. 0.38 ± 0.40 and 1.28 ± 0.93 vs. 0.25 ± 0.42; p < 0.0001 in both).
Conclusion: This is the first study to examine the relationship between mental health and rheumatoid arthritis in the Czech Republic. Clinical data indicate that RA patients with concurrent psychiatric comorbidities experience higher disease activity, poorer quality of life, and reduced functional abilities.
Keywords:
anxiety – rheumatoid arthritis – depression – mental health – suicidality – disease aktivity
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