Psychological state is related to the remission of the Boolean-based definition of patient global assessment in patients with rheumatoid arthritis

• Published in: Modern rheumatology Vol. 25; no. 5; pp. 679 - 682
• Main Authors: Fusama, Mie, Miura, Yasushi, Yukioka, Kumiko, Kuroiwa, Takanori, Yukioka, Chikako, Inoue, Miyako, Nakanishi, Tae, Murata, Norikazu, Takai, Noriko, Higashi, Kayoko, Kuritani, Taro, Maeda, Keiji, Sano, Hajime, Yukioka, Masao, Nakahara, Hideko
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 03.09.2015; Informa Healthcare
• Subjects: Adult; Aged; Aged, 80 and over; Antirheumatic Agents - therapeutic use; Anxiety; Anxiety - psychology; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - psychology; C-Reactive Protein - metabolism; Comparative analysis; Depression; Depression - psychology; Female; Humans; Male; Mental depression; Middle Aged; Patient global assessment; Proteins; Psychological remission; Remission Induction; Rheumatoid arthritis; Treatment Outcome; Depression; Anxiety; Patient global assessment; Rheumatoid arthritis; Psychological remission
• ISSN: 1439-7595; 1439-7609
• DOI: 10.3109/14397595.2015.1008955

Objectives. To evaluate whether the psychological state is related to the Boolean-based definition of patient global assessment (PGA) remission in patients with rheumatoid arthritis (RA). Methods. Patients with RA who met the criteria of swollen joint count (SJC) ≤ 1, tender joint count (TJC) ≤ 1 and C-reactive protein (CRP) ≤ 1 were divided into two groups, PGA remission group (PGA ≤ 1 cm) and non-remission group (PGA > 1 cm). Anxiety was evaluated utilizing the Hospital Anxiety and Depression Scale-Anxiety (HADS-A), while depression was evaluated with HADS-Depression (HADS-D) and the Center for Epidemiologic Studies Depression Scale (CES-D). Comparison analyses were done between the PGA remission and non-remission groups in HADS-A, HADS-D and CES-D. Results. Seventy-eight patients met the criteria for SJC ≤ 1, TJC ≤ 1 and CRP ≤ 1. There were no significant differences between the PGA remission group (n = 45) and the non-remission group (n = 33) in age, sex, disease duration and Steinbrocker's class and stage. HADS-A, HADS-D and CES-D scores were significantly lower in the PGA remission group. Conclusions. Patients with RA who did not meet the PGA remission criteria despite good disease condition were in a poorer psychological state than those who satisfied the Boolean-based definition of clinical remission. Psychological support might be effective for improvement of PGA, resulting in the attainment of true remission.