The Impact of Adequate Psychopharmacotherapy on the Efficiency of Treatment in Patients With Rheumatoid Arthritis

Абрамкин, А. А.; Лисицына, Т. А.; Veltishchev, D.; Seravina, O.; Kovalevskaya, O.; Насонов, Е. Л.

doi:10.14412/1995-4484-2018-173-183

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…Яльцевой и соавт. [37][38][39], где на фоне редукции симптомов тревоги и депрессивных расстройств продемонстрировано статистически значимое положительное влияние психофармакотерапии (ПФТ) РТДС на эффективность терапии РА, включая частоту достижения ремиссии, а также выраженность боли и функциональной недостаточности.…”

Section: депрессия и выраженность суставной деструкции у больных ревматоидным артритомunclassified

“…Отмеченное нами положительное воздействие ПФТ на замедление рентгенологического прогрессирования вряд ли связано с непосредственным влиянием на периферическое воспаление и эрозивный процесс. По всей видимости, данное наблюдение ассоциировано с исходно более низкой частотой максимальной деструкции в группе БПВП+ПФТ, а также является следствием более высокой эффективности терапии, связанной с повышением приверженности лечению РА на фоне редукции тревожных и депрессивных расстройств [37,38,59].…”

Section: ðåçóëüòàòûunclassified

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Depression and severity of articular destruction in patients with rheumatoid arthritis

Абрамкин

Лисицына

Veltishchev

et al. 2020

Terapevticheskii arkhiv

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Aim. To assess the influence of anxiety and depressive disorders on joint destruction in patients with rheumatoid arthritis (RA). Materials and methods. 128 RA-patients were included, 87% were women with a mean age of 47.411.3 years and a median of RA duration 96 [48; 228] months. At the inclusion most patients had moderate (n=56, 43.7%) and severe (n=48, 37.5%) disease activity according to DAS28. Joint destruction was classified as maximal in patients with radiographic stage III, IV and/or osteonecrosis) and minimal in patients with stage I, II and no osteonecrosis. Pain intensity was measured with the BPI (Brief Pain Inventory) scale, severity of fatigue with fatigue severity scale (FSS), clinically important fatigue was diagnosed in patients with FSS4. Anxiety and depressive disorders (ADD) were diagnosed by a licensed psychiatrist in 123 (96.1%) of RA-patients in accordance with ICD-10 in semi-structured interview. Severity of depression and anxiety was evaluated with Montgomery-Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Rating Scale (HAM-A). RA-patients with ADD were divided into the following treatment groups: 1 сDMARDs (n=39), 2 сDMARDs+PPT (sertraline or mianserine), n=43, 3 сDMARDs+bDMARDs (n=32), 4 сDMARDs+bDMARDs+PPT (sertraline or mianserine), n=9. Biologics treatment duration varied from 1 to 6 years, antidepressants from 6 to 96 weeks. 83 (67.5%) RA patients were assessed at five-years follow-up. Linear regression analysis was conducted to determine factors associated with maximal join destruction. Results. According to linear regression analysis, maximal joint destruction at 5 years follow-up was associated with higher baseline BPImax, longer RA and ADD duration, clinically important fatigue at baseline, baseline extraarticular RA manifestations, recurrent depressive disorder at 5-years follow-up and treatment with cDMARDs only. Conclusion. Recurrent depressive disorder without antidepressant treatment is an important predictor of progression of joint destruction in patients with rheumatoid arthritis.

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Section: депрессия и выраженность суставной деструкции у больных ревматоидным артритомunclassified

Section: ðåçóëüòàòûunclassified

Depression and severity of articular destruction in patients with rheumatoid arthritis

Абрамкин

Лисицына

Veltishchev

et al. 2020

Terapevticheskii arkhiv

Self Cite

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Neuropathic component of pain, comorbidity and quality of life in rheumathoid arthritis: are there any relationships?

Nikitina,

Egorova,

Bogdalova

et al. 2023

Profil. med.

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Stress, inflammation and coping strategies — association with rheumatological pathology

Teplyakova,

Kuvaeva,

Volkova

2023

Kazan Med J

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Stress, which inevitably occurs in the life of any person, affects various aspects of the functioning of the body and psyche. The purpose of the work is to summarize the results of review and empirical studies of the relationship between stress factors and changes in the activity of the immune system, affecting the patient’s choice of coping strategies and attitude to treatment. The impact of a stressor on the organs of the immune system occurs through activation of the autonomic nervous system and the hypothalamic-pituitary-adrenal axis and is accompanied by changes in the concentration of cytokines, the severity of cellular and humoral immunity. Short-term stressors significantly change the activity of the immune system by reducing the synthesis of Th1-type cytokines, reduce the severity of cellular immunity, but enhance humoral immunity. Chronic stressors have a negative impact on almost all functional indicators of the immune system. The results of the review indicate a close connection between coping behavior in a stressful situation and the activity of the immune system. The review examines the influence of family and man-made stressors on the activity of the immune system, the action of which leads to the formation of pro-inflammatory readiness of the body and an increase in the patient’s perception of pain, which increases the risk of developing rheumatological diseases under stressful living conditions. Isolated or lonely people are at greater risk of various inflammatory diseases and exhibit stronger inflammatory responses, leading to an increased risk of developing depressive symptoms. Turning to the construct of “coping intelligence” as a resource for preventive and personalized medicine allows us to describe two scenarios for changes in the immune system and the corresponding behavior of the patient and his attitude to treatment: (1) increased inflammation and increased vulnerability or (2) decreased inflammation and increased resistance to stress. Adaptive coping behavior allows people to effectively deal with stress, ensuring a person’s immunological stability by increasing the population of T helper cells and natural killer cells, thereby reducing the risk of developing rheumatological diseases.

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The Impact of Adequate Psychopharmacotherapy on the Efficiency of Treatment in Patients With Rheumatoid Arthritis

Cited by 3 publications

References 24 publications

Depression and severity of articular destruction in patients with rheumatoid arthritis

Depression and severity of articular destruction in patients with rheumatoid arthritis

Neuropathic component of pain, comorbidity and quality of life in rheumathoid arthritis: are there any relationships?

Stress, inflammation and coping strategies — association with rheumatological pathology

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