Depressão, ansiedade e atividade de doença na artrite reumatóide

Abstract

Objective: to evaluate the prevalence of psychiatric disorders in female patients, diagnosed with Rheumatoid Arthritis and relate this disorder to disease activity. Methods: sectional trial study with female patients, aged 18 years old or older, diagnosed with Rheumatoid Arthritis (following American College of Rheumatology-ACR criteria), more than six months of disease and incapacity levels II and III. Disease activity was evaluated with DAS 28 (Disease Activity Score-28) (remission up to 2.6/ moderate activity 2.6 to 5.1/severe degree over 5.1). Psychiatric evaluation was conducted using SCID protocol; interviews were held to diagnose the presence of depression and anxiety disorders following the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV TR). Statistical analysis included the Kruskal-Wallis test and the Kendall test with a significance level of 95%. Results: In the 107 patients analyzed, 36 subjects (33.7%) presented psychiatric disorders and 71(66.4%) no psychiatric disorders). Disease activity-DAS 28 score results; remission: 6 patients (5.6%); moderate activity: 59 patients (55.1%); severe disease: 42 patients (39.2%). The relationship between psychiatric disorders and disease activity (DAS 28) demonstrated: patients without psychiatric disorders-DAS 28 score: 4.56 and patients with psychiatric disorders, DAS 28 score: 5.43 (p=0.001). Conclusions: The prevalence of depression and anxiety disorders among 107 patients with Rheumatoid Arthritis was 33.7%. Disease activity, evaluated by the DAS 28 score, was higher in the group of patients with psychiatric disorders. No patients with psychiatric disorders were identified in the group in clinical remission.

Alterações psicológicas e exercício físico em pacientes com artrite reumatóide

“…Porém, atualmente não há consenso na literatura sobre a origem dessas alterações na saúde mental dos pacientes acometidos por essa patologia, sendo que isso poderia ocorrer em razão de sequelas de uma doença incapacitante ou da própria atividade clínica de uma doença inflamatória crônica, como a AR (Costa, Brasil, Papi, & Azevedo, 2008).…”

“…Recentemente foi demonstrado que a evolução da AR está intimamente relacionada com o aumento de ansiedade e depressão (Costa et al, 2008). Na pesquisa de Isik et al (2007), a prevalência total de desordens de ansiedade, depressão e ambas (ansiedadedepressão) foi de 70.8% em pacientes com AR e de 7.3% em indivíduos saudáveis.…”

“…Na pesquisa de Isik et al (2007), a prevalência total de desordens de ansiedade, depressão e ambas (ansiedadedepressão) foi de 70.8% em pacientes com AR e de 7.3% em indivíduos saudáveis. Já num estudo realizado no Brasil, encontrou-se uma prevalência em torno de 34% de transtornos depressivos e ansiosos nesses pacientes (Costa et al, 2008).…”

Influence of chronic pain on functional capacity of the elderly

“…Rheumatoid arthritis (RA) is an inflammatory joint disease of chronic evolution, characterized by painful events and physical deformities, with consequent limitations for work and daily activities 18 . The disease evolves with different levels of functional incapacity and is associated to increased morbidity and mortality rates as compared to normal population 19 .…”

Impact of Different Levels of Disease Activity in Painful Profile and Quality of Life in People With Rheumatoid Arthritis

“…(1) This condition is be classified according to the level of disease activity (LDA) as in remission, mild, moderate or severe by the Disease Activity Score (DAS28). (2) The main complaint of patients with RA is the presence of pain, followed by functional disability when performing daily activities. (3,4) The pain may be nociceptive (caused by activation of nociceptors), neuropathic (resulting from alteration or damage to the nervous system) or mixed (showing both neuropathic and nociceptive components).…”