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Current Rheumatology Reviews


ISSN (Print): 1573-3971
ISSN (Online): 1875-6360

Research Article

Prevalence of Anxiety, Depression, Sleep Disturbance, Fibromyalgia, Obesity, and Gastroesophageal Disease in Patients with Rheumatic Diseases

Author(s): Azin Azarfar*, Ali Ahmed and Shazia Bég

Volume 17, Issue 2, 2021

Published on: 11 December, 2020

Page: [252 - 257] Pages: 6

DOI: 10.2174/1573397116666201211124815

Price: $65


Background: Patients with rheumatologic disorders often have comorbidities that complicate their psychological well-being. In this study, we looked at 216 patients with rheumatoid arthritis (RA), systemic lupus erythematous (SLE), psoriatic arthritis (PsA), and Sjogren’s syndrome (SS) to determine the prevalence of anxiety, depression, sleep disturbance, fibromyalgia (FM), obesity (BMI greater than 23), and gastroesophageal disease (GERD) and the correlation between FM, BMI, disease activity measure, known as Routine Assessment of Patient Index Data 3 (RAPID3).

Methods: Study participants were 216 rheumatology patients seen at the UCF Pegasus Health Clinic from November 2011 to May 2014 with one or more of the following diseases: RA, SS, SLE, or PsA. 116 had rheumatoid arthritis, 27 with systemic lupus erythematous, 22 with psoriatic arthritis, 20 with Sjogren’s syndrome, and 31 with more than one diagnosis. Variables that were collected from patients’ charts included RAPID3 scores, patient demographics (age, sex), BMI, presence of GERD, and presence of FM. Each patient was randomly assigned, unique and had an unidentifiable study number.

Results: Anxiety, depression, sleep disturbance and obesity were found to be more prevalent in patients with Sjogren’s syndrome, and fibromyalgia was noted to be more prevalent in patients with more than 1 diagnosis. The presence of fibromyalgia was significantly correlated with higher RAPID3 scores in all patients except those with PsA. Significant correlation among higher BMI and greater RAPID3 scores was found for patients with rheumatoid arthritis and for patients with Sjogren’s syndrome.

Conclusion: Our study showed an increased prevalence of anxiety in patients with Sjogren’s syndrome. Fibromyalgia was found to be related to higher disease activity scores. In RA and SS patients, BMI was significantly correlated with higher RAPID3 scores. These results provide a basis for future studies to evaluate these correlations in more detail.

Keywords: Rheumatoid arthritis, systemic lupus erythematous, psoriatic arthritis, Sjogren’s syndrome, gastroesophageal disease, fibromyalgia, body mass index.

Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry 1994; 51(1): 8-19.
[] [PMID: 8279933]
Geenen R, Newman S, Bossema ER, Vriezekolk JE, Boelen PA. Psychological interventions for patients with rheumatic diseases and anxiety or depression. Best Pract Res Clin Rheumatol 2012; 26(3): 305-19.
[] [PMID: 22867928]
Matcham F, Norton S, Scott DL, Steer S, Hotopf M. Symptoms of depression and anxiety predict treatment response and long-term physical health outcomes in rheumatoid arthritis: secondary analysis of a randomized controlled trial. Rheumatology (Oxford) 2016; 55(2): 268-78.
[] [PMID: 26350486]
Karaiskos D, Mavragani CP, Sinno MH, et al. Psychopathological and personality features in primary Sjogren’s syndrome--associations with autoantibodies to neuropeptides. Rheumatology (Oxford) 2010; 49(9): 1762-9.
[] [PMID: 20525741]
Rathbun AM, Reed GW, Harrold LR. The temporal relationship between depression and rheumatoid arthritis disease activity, treatment persistence and response: a systematic review. Rheumatology (Oxford) 2013; 52(10): 1785-94.
[] [PMID: 23236191]
Matcham F, Davies R, Hotopf M, et al. The relationship between depression and biologic treatment response in rheumatoid arthritis: An analysis of the British Society for Rheumatology Biologics Register. Rheumatology (Oxford) 2018; 57(5): 835-43.
[] [PMID: 29447376]
Anyfanti P, Gavriilaki E, Pyrpasopoulou A, et al. Depression, anxiety, and quality of life in a large cohort of patients with rheumatic diseases: common, yet undertreated. Clin Rheumatol 2016; 35(3): 733-9.
[] [PMID: 24859781]
Sariyildiz MA, Batmaz I, Bozkurt M, et al. Sleep quality in rheumatoid arthritis: relationship between the disease severity, depression, functional status and the quality of life. J Clin Med Res 2014; 6(1): 44-52.
[PMID: 24400031]
Irwin MR, Olmstead R, Carrillo C, et al. Sleep loss exacerbates fatigue, depression, and pain in rheumatoid arthritis. Sleep (Basel) 2012; 35(4): 537-43.
[] [PMID: 22467992]
Nicassio PM, Ormseth SR, Kay M, et al. The contribution of pain and depression to self-reported sleep disturbance in patients with rheumatoid arthritis. Pain 2012; 153(1): 107-12.
[] [PMID: 22051047]
Atzeni F, Cazzola M, Benucci M, Di Franco M, Salaffi F, Sarzi-Puttini P. Chronic widespread pain in the spectrum of rheumatological diseases. Best Pract Res Clin Rheumatol 2011; 25(2): 165-71.
[] [PMID: 22094193]
El-Rabbat M S, Mahmoud NK, Gheita TA. Clinical significance of fibromyalgia syndrome in different rheumatic diseases: Relation to disease activity and quality of life. Reumatol Clin 2018; 14(5): 285-9.
[] [PMID: 28411133]
Buskila D, Press J, Abu-Shakra M. Fibromyalgia in systemic lupus erythematosus: prevalence and clinical implications. Clin Rev Allergy Immunol 2003; 25(1): 25-8.
[] [PMID: 12794258]
Iannuccelli C, Spinelli FR, Guzzo MP, et al. Fatigue and widespread pain in systemic lupus erythematosus and Sjögren’s syndrome: symptoms of the inflammatory disease or associated fibromyalgia? Clin Exp Rheumatol 2012; 30(6)(Suppl. 74): 117-21.
[PMID: 23261010]
Cojocaru M, Cojocaru IM, Silosi I, Vrabie CD. Gastrointestinal manifestations in systemic autoimmune diseases. Maedica (Bucur) 2011; 6(1): 45-51.
[PMID: 21977190]
Nampei A, Shi K, Ebina K, et al. Prevalence of gastroesophageal reflux disease symptoms and related factors in patients with rheumatoid arthritis. J Clin Biochem Nutr 2013; 52(2): 179-84.
[] [PMID: 23525140]
Ajeganova S, Andersson ML, Hafström I. BARFOT Study Group. Association of obesity with worse disease severity in rheumatoid arthritis as well as with comorbidities: a long-term followup from disease onset. Arthritis Care Res (Hoboken) 2013; 65(1): 78-87.
[] [PMID: 22514159]
Gremese E, Carletto A, Padovan M, et al. Gruppo Italiano di Studio sulle Early Arthritis (GISEA). Obesity and reduction of the response rate to anti-tumor necrosis factor α in rheumatoid arthritis: an approach to a personalized medicine. Arthritis Care Res (Hoboken) 2013; 65(1): 94-100.
[] [PMID: 22730143]
Klaasen R, Wijbrandts CA, Gerlag DM, Tak PP. Body mass index and clinical response to infliximab in rheumatoid arthritis. Arthritis Rheum 2011; 63(2): 359-64.
[] [PMID: 21279992]
Hollan I, Meroni PL, Ahearn JM, et al. Cardiovascular disease in autoimmune rheumatic diseases. Autoimmun Rev 2013; 12(10): 1004-15.
[] [PMID: 23541482]
Baker JF, Ostergaard M, George M, et al. Greater body mass independently predicts less radiographic progression on X-ray and MRI over 1-2 years. Ann Rheum Dis 2014; 73(11): 1923-8.
[] [PMID: 25091439]
Chong VH, Wang CL. Higher prevalence of gastrointestinal symptoms among patients with rheumatic disorders. Singapore Med J 2008; 49(5): 419-24.
[PMID: 18465055]
Miura Y, Fukuda K, Maeda T, Kurosaka M. Gastroesophageal reflux disease in patients with rheumatoid arthritis. Mod Rheumatol 2014; 24(2): 291-5.
[] [PMID: 24252041]
Pincus T, Bergman MJ, Yazici Y. RAPID3-an index of physical function, pain, and global status as “vital signs” to improve care for people with chronic rheumatic diseases. Bull NYU Hosp Jt Dis 2009; 67(2): 211-25.
[PMID: 19583557]
National Institutes of Health. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults--The Evidence Report. Obes Res 1998; 6(Suppl. 2): 51S-209S.
[PMID: 9813653]
Matcham F, Rayner L, Steer S, Hotopf M. The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology (Oxford) 2013; 52(12): 2136-48.
[] [PMID: 24003249]
Abbasi M, Yazdi Z, Rezaie N. Sleep disturbances in patients with rheumatoid arthritis. Niger J Med 2013; 22(3): 181-6.
[PMID: 24180144]
Haliloglu S, Carlioglu A, Akdeniz D, Karaaslan Y, Kosar A. Fibromyalgia in patients with other rheumatic diseases: prevalence and relationship with disease activity. Rheumatol Int 2014; 34(9): 1275-80.
[] [PMID: 24589726]
Covic T, Cumming SR, Pallant JF, et al. Depression and anxiety in patients with rheumatoid arthritis: prevalence rates based on a comparison of the Depression, Anxiety and Stress Scale (DASS) and the hospital, Anxiety and Depression Scale (HADS). BMC Psychiatry 2012; 12: 6.
[] [PMID: 22269280]
Hanly JG, Fisk JD, McCurdy G, Fougere L, Douglas JA. Neuropsychiatric syndromes in patients with systemic lupus erythematosus and rheumatoid arthritis. J Rheumatol 2005; 32(8): 1459-6.
[PMID: 16078320]
Nery FG, Borba EF, Viana VS, et al. Prevalence of depressive and anxiety disorders in systemic lupus erythematosus and their association with anti-ribosomal P antibodies. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32(3): 695-700.
[] [PMID: 18077068]
Cordingley L, Prajapati R, Plant D, et al. Biologics in Rheumatoid Arthritis Genetics and Genomics Study Syndicate (BRAGGSS). Impact of psychological factors on subjective disease activity assessments in patients with severe rheumatoid arthritis. Arthritis Care Res (Hoboken) 2014; 66(6): 861-8.
[] [PMID: 24339425]
Margaretten M, Julian L, Katz P, Yelin E. Depression in patients with rheumatoid arthritis: description, causes and mechanisms. Int J Clin Rheumatol 2011; 6(6): 617-23.
[] [PMID: 22211138]
Giannelou M, Tseronis D, Antypa E, Mavragani CP. Anxiety and extraversion in lupus-related atherosclerosis. Front Psychiatry 2018; 9: 246.
[] [PMID: 29971022]
Giannelou M, Mavragani CP. Cardiovascular disease in systemic lupus erythematosus: A comprehensive update. J Autoimmun 2017; 82: 1-12.
[] [PMID: 28606749]
Kotsis K, Voulgari PV, Tsifetaki N, Drosos AA, Carvalho AF, Hyphantis T. Illness perceptions and psychological distress associated with physical health-related quality of life in primary Sjögren’s syndrome compared to systemic lupus erythematosus and rheumatoid arthritis. Rheumatol Int 2014; 34(12): 1671-81.
[] [PMID: 24769916]
Leger D, Poursain B, Neubauer D, Uchiyama M. An international survey of sleeping problems in the general population. Curr Med Res Opin 2008; 24: 307-17.
[PMID: 25639339]
Karageorgas T, Fragioudaki S, Nezos A, Karaiskos D, Moutsopoulos HM, Mavragani CP. Fatigue in primary Sjögren’s syndrome: clinical, laboratory, psychometric, and biologic associations. Arthritis Care Res (Hoboken) 2016; 68(1): 123-31.
[] [PMID: 26315379]
Iannone F, Lopalco G, Rigante D, Orlando I, Cantarini L, Lapadula G. Impact of obesity on the clinical outcome of rheumatologic patients in biotherapy. Autoimmun Rev 2016; 15(5): 447-50.
[] [PMID: 26808074]

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