The association between anxiety and disease activity and quality of life in rheumatoid arthritis: a systematic review and meta-analysis

Machin, Annabelle; Babatunde, Opeyemi; Haththotuwa, Randula; Scott, Ian C.; Blagojevic‐Bucknall, Milica; Corp, Nadia; Chew‐Graham, Carolyn; Hider, Samantha L.

doi:10.1007/s10067-019-04900-y

Cited by 51 publications

(35 citation statements)

References 38 publications

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“…In our study, patient global VAS correlated with anxiety levels, which could partially explain the association between anxiety and worse disease activity outcomes in RA. 25 However, in contrast to what we observed for depression in our cohort (as outlined above), anxiety was not associated with CRP, neither in univariate nor in multivariable analysis. The reasons for this are not clear and merit further investigation.…”

Section: Discussioncontrasting

confidence: 94%

Depression and anxiety in an early rheumatoid arthritis inception cohort. associations with demographic, socioeconomic and disease features

et al. 2020

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ObjectiveDepression and anxiety are not uncommon in Rheumatoid arthritis (RA). It is increasingly recognised that they are associated with high disease activity and worse disease outcomes. We aimed to examine the frequency of depression and anxiety in an early RA inception cohort and to explore associations with disease-related measures.MethodsThe Scottish Early Rheumatoid Arthritis inception cohort recruited newly diagnosed RA patients followed-up 6-monthly. Anxiety and depression were assessed using the hospital anxiety and depression scale. Associations with demographic characteristics and disease-related measures were examined at baseline, 6 months and 12 months.Results848 RA patients were included. The prevalence of anxiety and depression at baseline was 19.0% and 12.2%, respectively. Depression and anxiety scores correlated with DAS28 at all time-points (all p<0.0001). In multivariable linear regression, anxiety score at baseline was associated with younger age and Health Assessment Questionnaire (HAQ) score. Anxiety scores at 6 months and 12 months were associated with low body mass index (BMI), baseline anxiety score and current patient global score and HAQ. Depression score at baseline was associated with younger age, being single and HAQ, while depression scores at 6 months and 12 months were associated with male gender (only at 6 months), baseline anxiety and depression scores and current patient global score, HAQ and C-reactive protein (CRP) levels.ConclusionDepression and anxiety are associated with disease activity, worse functional status and other variables in early RA. There is a close relationship between CRP and depression but not anxiety.

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Section: Discussioncontrasting

confidence: 94%

Depression and anxiety in an early rheumatoid arthritis inception cohort. associations with demographic, socioeconomic and disease features

et al. 2020

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“…In Italy, RA affects between 0.41 and 0.48% of the population and the prevalence of SpA is similar, with ankylosing spondylitis at 0.37% and psoriatic arthritis at 0.42%, accounting for a total of about 700.000-800.000 Italians, confirming the importance of autoimmune arthritis as a public health issue [23,24]. It has already been demonstrated that both depression and anxiety are prevalent in these patients with respect to the general population, and a particular need for mental healthcare in this population has been proposed [25][26][27][28][29][30][31][32][33]. The management of patients affected by chronic diseases, such as arthritis, has become significantly more complex in this COVID-19 scenario, for a number of reasons.…”

Section: Introductionmentioning

confidence: 76%

“…Mental health status was measured using the Depression, Anxiety, and Stress Scale (DASS-21), a standardized and validated scale already used in chronic arthritis patients, as well as in previous research related to SARS and COVID-19 [43,44]. The total depression subscale score was divided into normal (0-9), mild depression (10)(11)(12), moderate depression (13)(14)(15)(16)(17)(18)(19)(20), severe depression (21-27), and extremely severe depression (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). The total anxiety subscale score was divided into normal (0-6), mild anxiety (7-9), moderate anxiety (10)(11)(12)(13)(14), severe anxiety (15)(16)(17)(18)(19), and extremely severe anxiety .…”

Section: Methodsmentioning

confidence: 99%

“…The total anxiety subscale score was divided into normal (0-6), mild anxiety (7-9), moderate anxiety (10)(11)(12)(13)(14), severe anxiety (15)(16)(17)(18)(19), and extremely severe anxiety . The total stress subscale score was divided into normal (0-10), mild stress (11-18), moderate stress (19)(20)(21)(22)(23)(24)(25)(26), severe stress (27)(28)(29)(30)(31)(32)(33)(34), and extremely severe stress (35)(36)(37)(38)(39)(40)(41)(42).…”

Section: Methodsmentioning

confidence: 99%

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Psychological Distress in Patients with Autoimmune Arthritis during the COVID-19 Induced Lockdown in Italy

et al. 2020

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Lockdowns imposed by governments worldwide as a way to limit the spread of severe atypical respiratory syndrome-coronavirus-2 (SARS-CoV2) have had heavy psychological and economic consequences. Arthritis patients are a vulnerable population at an increased risk of peritraumatic stress. This could be due to several reasons, including the fear of shortage of medicine and difficulty receiving periodical medical checks. In the present case-control study, psychological distress in patients with autoimmune arthritis during the coronavirus disease 2019 (COVID-19) pandemic were investigated. An electronic survey was conducted to gather information on the perceived change in the emotional state, general health (GH), fatigue, joint pain, and disease activity during the lockdown, in 100 patients with autoimmune arthritis and 100 controls. Mental health status was measured using the Depression, Anxiety and Stress Scale (DASS-21). The COVID-19 Peritraumatic Distress Index (CPDI) was used to assess the frequency of peritraumatic stress disorders related to COVID-19. Patients reported a significant worsening of perceived GH (36% vs. 7%; p < 0.001), a significantly higher mean CPDI score (p < 0.001) than controls. Using multivariate analysis, arthritis patients had significantly higher CPDI scores (+3.67 points; p = 0.019), independent of depression, anxiety, and stress symptoms, comorbidities, and sociodemographic and lifestyle characteristics. Logistic regression analysis showed that the risk of reporting worsened GH was 9-fold higher in patients than controls (p < 0.001). Patients with autoimmune arthritis are at higher risk of psychological distress related to COVID-19 pandemic; thus targeted intervention should be designed to strengthen coping capacity in this vulnerable population.

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“…Inflammatory arthritis is characterized by an inflammation of the synovial membrane (synovitis), which leads to disability and a substantial reduction in quality of life [ 1 ]. The inflamed synovium contains infiltrated inflammatory cells (activated T cells and macrophages), as well as an excess of pro-inflammatory cytokines (interleukin-1 (IL-1) and Tumor Necrosis Factor alpha (TNFα)), accelerating thereby the production of reactive oxygen species (ROS) and connective tissue damages [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

1H-NMR-Based Analysis for Exploring Knee Synovial Fluid Metabolite Changes after Local Cryotherapy in Knee Arthritis Patients

et al. 2020

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Rehabilitation using cryotherapy has widely been used in inflammatory diseases to relieve pain and decrease the disease activity. The aim of this study was to explore the metabolite changes in inflammatory knee-joint synovial fluids following local cryotherapy treatment (ice or cold CO2). We used proton nuclear magnetic resonance (1H NMR) spectroscopy to assess the metabolite patterns in synovial fluid (SF) in patients with knee arthritis (n = 46) before (D0) and after (D1, 24 h later) two applications of local cryotherapy. Spectra from aqueous samples and organic extracts were obtained with an 11.75 Tesla spectrometer. The metabolite concentrations within the SF were compared between D1 and D0 using multiple comparisons with the application of a false discovery rate (FDR) adjusted at 10% for each metabolite. A total of 32 metabolites/chemical structures were identified including amino acids, organic acids, fatty acids or sugars. Pyruvate, alanine, citrate, threonine was significantly higher at D1 vs D0 (p < 0.05). Tyrosine concentration significantly decreases after cryotherapy application (p < 0.001). We did not observe any effect of gender and cooling technique on metabolite concentrations between D0 and D1 (p > 0.05). The present study provides new insight into a short-term effect of cold stimulus in synovial fluid from patients with knee arthritis. Our observations suggest that the increased level of metabolites involved in energy metabolism may explain the underlying molecular pathways that mediate the antioxidant and anti-inflammatory capacities of cryotherapy.

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The association between anxiety and disease activity and quality of life in rheumatoid arthritis: a systematic review and meta-analysis

Cited by 51 publications

References 38 publications

Depression and anxiety in an early rheumatoid arthritis inception cohort. associations with demographic, socioeconomic and disease features

Depression and anxiety in an early rheumatoid arthritis inception cohort. associations with demographic, socioeconomic and disease features

Psychological Distress in Patients with Autoimmune Arthritis during the COVID-19 Induced Lockdown in Italy

1H-NMR-Based Analysis for Exploring Knee Synovial Fluid Metabolite Changes after Local Cryotherapy in Knee Arthritis Patients

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