The association of fatigue, pain, depression and anxiety with work and activity impairment in immune mediated inflammatory diseases

Abstract

Impairment in work function is a frequent outcome in patients with chronic conditions such as immune-mediated inflammatory diseases (IMID), depression and anxiety disorders. The personal and economic costs of work impairment in these disorders are immense. Symptoms of pain, fatigue, depression and anxiety are potentially remediable forms of distress that may contribute to work impairment in chronic health conditions such as IMID. The present study evaluated the association between pain [Medical Outcomes Study Pain Effects Scale], fatigue [Daily Fatigue Impact Scale], depression and anxiety [Hospital Anxiety and Depression Scale] and work impairment [Work Productivity and Activity Impairment Scale] in four patient populations: multiple sclerosis (n = 255), inflammatory bowel disease (n = 248, rheumatoid arthritis (n = 154) and a depression and anxiety group (n = 307), using quantile regression, controlling for the effects of sociodemographic factors, physical disability, and cognitive deficits. Each of pain, depression symptoms, anxiety symptoms, and fatigue individually showed significant associations with work absenteeism, presenteeism, and general activity impairment (quantile regression standardized estimates ranging from 0.3 to 1.0). When the distress variables were entered concurrently into the regression models, fatigue was a significant predictor of work and activity impairment in all models (quantile regression standardized estimates ranging from 0.2 to 0.5). These findings have important clinical implications for understanding the determinants of work impairment and for improving work-related outcomes in chronic disease.

Fatigue in Inflammatory Bowel Diseases: Etiologies and Management

“…There was also higher indirect medical costs in patients with IBD than controls ($17,766 per year versus $9179 per year, respectively, p \ 0.03) [14]. Another study corroborated this association of fatigue with presenteeism and general activity impairment in patients with IBD, rheumatoid arthritis, and multiple sclerosis after controlling for sociodemographic factors, cognitive impairment, and disability [15].…”

The Anxiety Status of Chinese Medical Workers During the Epidemic of COVID-19: A Meta-Analysis

“…Psychological factors have a certain impact on the fight against 2019-nCoV, for example, anxiety may not only affect the medical workers' attention, understanding, and decision making ability, [29][30][31] but also result in decreased resistance, insomnia and other adverse physical and mental reactions. 32,33 The coping mechanisms, developed by Aguilera 34 based 1994 on Caplan' s theory, refer to the usual patterns of reaction when a subject faces a problem. Medical workers are expected to believe that they can effectively manage current situations, and the perceived control of certain circumstances will affect their choice and insistence on coping strategies.…”

Biological Therapies in Immune-Mediated Inflammatory Diseases: Can Biosimilars Reduce Access Inequities?

“…Biological therapies such as anti-tumor necrosis factor (TNF) and anti-interleukin antibodies are widely used for a range of immune-mediated inflammatory diseases (IMIDs), including rheumatoid arthritis (RA) (Smolen et al, 2016), psoriasis (PsO), and psoriatic arthritis (Boehncke and Schon, 2015), Crohn’s disease (CD) (Baumgart and Sandborn, 2012) and ulcerative colitis (UC) (Ordás et al, 2012; Fiorino et al, 2014). Many of these conditions are associated with pain, progressive disability and loss of ability to work (Wolfe and Hawley, 1998; Rapp et al, 1999; Birch and Bhattacharya, 2010; Scott et al, 2010; Tillett et al, 2012; Busch et al, 2014; McWilliams et al, 2014; Carneiro et al, 2017; Husni et al, 2017; Takeshita et al, 2017; Enns et al, 2018; Wu et al, 2018). Furthermore, the prevalence of psychiatric comorbidities such as depression and anxiety can be high in chronic inflammatory diseases (Enns et al, 2018).…”

“…Many of these conditions are associated with pain, progressive disability and loss of ability to work (Wolfe and Hawley, 1998; Rapp et al, 1999; Birch and Bhattacharya, 2010; Scott et al, 2010; Tillett et al, 2012; Busch et al, 2014; McWilliams et al, 2014; Carneiro et al, 2017; Husni et al, 2017; Takeshita et al, 2017; Enns et al, 2018; Wu et al, 2018). Furthermore, the prevalence of psychiatric comorbidities such as depression and anxiety can be high in chronic inflammatory diseases (Enns et al, 2018).…”