Successful psychopharmacotherapy of anxiety and depressive disorders improve functional limitations in patients with rheumatoid arthritis
Aim. To compare changes in functional limitations in patients with rheumatoid arthritis (RA) and comorbid anxiety and depressive disorders (ADD) treated with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) alone or in combination with biologic DMARDs (bDMARDs) and/or psychoph...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | Russian |
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"Consilium Medicum" Publishing house
2022-06-01
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| Series: | Терапевтический архив |
| Subjects: | |
| Online Access: | https://ter-arkhiv.ru/0040-3660/article/viewFile/108777/82888 |
| _version_ | 1811343492491771904 |
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| author | Anton A. Abramkin Tatiana A. Lisitsyna Dmitry Yu. Veltishchev Olga F. Seravina Oksana B. Kovalevskaya Svetlana I. Glukhova Evgeny L. Nasonov |
| author_facet | Anton A. Abramkin Tatiana A. Lisitsyna Dmitry Yu. Veltishchev Olga F. Seravina Oksana B. Kovalevskaya Svetlana I. Glukhova Evgeny L. Nasonov |
| author_sort | Anton A. Abramkin |
| collection | DOAJ |
| description | Aim. To compare changes in functional limitations in patients with rheumatoid arthritis (RA) and comorbid anxiety and depressive disorders (ADD) treated with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) alone or in combination with biologic DMARDs (bDMARDs) and/or psychopharmacotherapy (PPT), and to determine predictors of HAQ treatment response.
Materials and methods. 128 RA-patients were enrolled, 86% were women with a mean age of 47.411.3 (MSD) years and a median of RA duration 96 [48; 228] months. Disease activity was assessed using DAS28, functional limitations using Health Assessment Questionnaire (HAQ). The Minimal Clinical Important Difference in HAQ was considered to be 0.22. ADD were diagnosed by a licensed psychiatrist in 123 (96.1%) of RA-pts in accordance with ICD-10 in semi-structured interview. Severity of depression and anxiety was evaluated with MontgomeryAsberg Depression Rating Scale and Hamilton Anxiety Rating Scale. RA-pts with ADD were divided into the following treatment groups: 1 сsDMARDs (n=39), 2 сsDMARDs + PPT (sertraline or mianserine; n=43), 3 сsDMARDs + bDMARDs (n=32), 4 сsDMARDs + bDMARDs + PPT (sertraline or mianserine; n=9); 83 (67.5%) patients were assessed at 5-years follow-up. Multivariable logistic regression was performed to determine predictors of HAQ treatment response.
Results. Only remission of anxiety and depressive symptoms at 5-yrs endpoint (OR 6.6, 95% CI 1.7824.43, p=0.005), higher baseline HAQ (OR 2.61, 95% CI 1.126.11, p=0.027) and lower baseline BMI (OR 0.9, 95% CI 0.850.96, p=0.001) were independently associated with HAQ treatment response at 5-years follow-up.
Conclusion. While ADD do affect functional limitations in patients with RA, PPT tends to attenuate the negative impact of ADD on RA outcomes, and RA patients with functional limitations should therefore be screened for depression and long-term PPT should be recommended. |
| first_indexed | 2024-04-13T19:31:18Z |
| format | Article |
| id | doaj.art-8b176cfe2e444499ae01ecfff32ae89a |
| institution | Directory Open Access Journal |
| issn | 0040-3660 2309-5342 |
| language | Russian |
| last_indexed | 2024-04-13T19:31:18Z |
| publishDate | 2022-06-01 |
| publisher | "Consilium Medicum" Publishing house |
| record_format | Article |
| series | Терапевтический архив |
| spelling | doaj.art-8b176cfe2e444499ae01ecfff32ae89a2022-12-22T02:33:11Zrus"Consilium Medicum" Publishing houseТерапевтический архив0040-36602309-53422022-06-0194561662110.26442/00403660.2022.05.20151478111Successful psychopharmacotherapy of anxiety and depressive disorders improve functional limitations in patients with rheumatoid arthritisAnton A. Abramkin0https://orcid.org/0000-0002-1504-5645Tatiana A. Lisitsyna1https://orcid.org/0000-0001-9437-406XDmitry Yu. Veltishchev2https://orcid.org/0000-0001-5210-2605Olga F. Seravina3https://orcid.org/0000-0001-5839-4637Oksana B. Kovalevskaya4https://orcid.org/0000-0001-6573-4337Svetlana I. Glukhova5https://orcid.org/0000-0002-4285-0869Evgeny L. Nasonov6https://orcid.org/0000-0002-1598-8360Nasonova Research Institute of RheumatologyNasonova Research Institute of RheumatologyMoscow Research Institute of Psychiatry – branch of the Serbsky National Medical Research Center of Psychiatry and NarcologyMoscow Research Institute of Psychiatry – branch of the Serbsky National Medical Research Center of Psychiatry and NarcologyMoscow Research Institute of Psychiatry – branch of the Serbsky National Medical Research Center of Psychiatry and NarcologyNasonova Research Institute of RheumatologyNasonova Research Institute of RheumatologyAim. To compare changes in functional limitations in patients with rheumatoid arthritis (RA) and comorbid anxiety and depressive disorders (ADD) treated with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) alone or in combination with biologic DMARDs (bDMARDs) and/or psychopharmacotherapy (PPT), and to determine predictors of HAQ treatment response. Materials and methods. 128 RA-patients were enrolled, 86% were women with a mean age of 47.411.3 (MSD) years and a median of RA duration 96 [48; 228] months. Disease activity was assessed using DAS28, functional limitations using Health Assessment Questionnaire (HAQ). The Minimal Clinical Important Difference in HAQ was considered to be 0.22. ADD were diagnosed by a licensed psychiatrist in 123 (96.1%) of RA-pts in accordance with ICD-10 in semi-structured interview. Severity of depression and anxiety was evaluated with MontgomeryAsberg Depression Rating Scale and Hamilton Anxiety Rating Scale. RA-pts with ADD were divided into the following treatment groups: 1 сsDMARDs (n=39), 2 сsDMARDs + PPT (sertraline or mianserine; n=43), 3 сsDMARDs + bDMARDs (n=32), 4 сsDMARDs + bDMARDs + PPT (sertraline or mianserine; n=9); 83 (67.5%) patients were assessed at 5-years follow-up. Multivariable logistic regression was performed to determine predictors of HAQ treatment response. Results. Only remission of anxiety and depressive symptoms at 5-yrs endpoint (OR 6.6, 95% CI 1.7824.43, p=0.005), higher baseline HAQ (OR 2.61, 95% CI 1.126.11, p=0.027) and lower baseline BMI (OR 0.9, 95% CI 0.850.96, p=0.001) were independently associated with HAQ treatment response at 5-years follow-up. Conclusion. While ADD do affect functional limitations in patients with RA, PPT tends to attenuate the negative impact of ADD on RA outcomes, and RA patients with functional limitations should therefore be screened for depression and long-term PPT should be recommended.https://ter-arkhiv.ru/0040-3660/article/viewFile/108777/82888rheumatoid arthritisanxietydepressionantidepressantshaqpredictorsfunctional limitations |
| spellingShingle | Anton A. Abramkin Tatiana A. Lisitsyna Dmitry Yu. Veltishchev Olga F. Seravina Oksana B. Kovalevskaya Svetlana I. Glukhova Evgeny L. Nasonov Successful psychopharmacotherapy of anxiety and depressive disorders improve functional limitations in patients with rheumatoid arthritis Терапевтический архив rheumatoid arthritis anxiety depression antidepressants haq predictors functional limitations |
| title | Successful psychopharmacotherapy of anxiety and depressive disorders improve functional limitations in patients with rheumatoid arthritis |
| title_full | Successful psychopharmacotherapy of anxiety and depressive disorders improve functional limitations in patients with rheumatoid arthritis |
| title_fullStr | Successful psychopharmacotherapy of anxiety and depressive disorders improve functional limitations in patients with rheumatoid arthritis |
| title_full_unstemmed | Successful psychopharmacotherapy of anxiety and depressive disorders improve functional limitations in patients with rheumatoid arthritis |
| title_short | Successful psychopharmacotherapy of anxiety and depressive disorders improve functional limitations in patients with rheumatoid arthritis |
| title_sort | successful psychopharmacotherapy of anxiety and depressive disorders improve functional limitations in patients with rheumatoid arthritis |
| topic | rheumatoid arthritis anxiety depression antidepressants haq predictors functional limitations |
| url | https://ter-arkhiv.ru/0040-3660/article/viewFile/108777/82888 |
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