Clinical analysis of psychological problems in patients with rheumatic diseases
10.3760/cma.j.issn.1007-7480.2017.07.010
- VernacularTitle:风湿性疾病伴发心理症状的临床分析
- Author:
Xiaomeng LUO
;
Ying LIU
;
Weiguo XIAO
- Keywords:
Rheumatic diseases;
Depression;
Anxiety;
Personality;
Influence factors
- From:
Chinese Journal of Rheumatology
2017;21(7):475-479
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the mental status and its influencing factors of patients with rheumatic disease. Methods Three hundreds and eighty-one patients with rheumatic diseases were assessed with the self-rating anxiety scale, self-rating depressive scale, Eysenck Personality Questionnaire symptom checklist-90, and demographic characteristics questionnaire. The comparison among groups were tested by t tests, Spearman's correlation analysis. Results Patients with anxiety symptoms accounted for 35.96%, and pre-valence rate of depression was 48.03%. The gender (r=0.87, OR=2.34) and duration (r=0.006, OR=1.006) were the risk factors and the C4 (r=-2.63, OR=0.07) was the protective factor. In patients with systemic lupus erythematosus, depression was related to education (Z=2.228, P=0.026), disease duration (Z=-2.015,P=0.044), IgG level (t=-2.266, P=0.027), T cell subsets CD8 (Z=1.981, P=0.047) and CD3 (Z=1.967, P=0.049). Anxiety was related to education (Z=2.452, P=0.014), duration (Z=-2.054, P=0.04), complement C3 (t=2.035, P=0.045), C4 (Z=-2.204, P=0.028) and IgG level (t=-2.126, P=0.036). The value of CRP(Z=-1.984, P=0.047) and IgM (t=2.243, P=0.028) of rheumatoid arthritis patients were higher in the depression group. The depression group was different in disease duration (Z=-2.631, P=0.009), gender ( χ2=4.415, P=0.042), ESR (Z=2.17, P=0.023) and CD3 cell (Z=2.023, P=0.043) in Sj?gren's syndrome patients. Correlation analysis showed positive correlation between the score of SDS, SAS and the P value (r=0.21, P=0.01) (r=0.14, P=0.007) N dimension (r=0.52, P=0.01) (r=0.55, P=0.007) of EPQ. There were negative correlation between the score of SDS, SAS and the E dimension (r=-0.23, P=0.01) (r=-0.14, P=0.006) of EPQ. Conclusion The prevalence of depres-sion and anxiety is higher in patients with depressive and anxious symptoms. They are in older age, female gender, poor education, longer duration, lower complement and lower T cell subsets when compared with those patients without depression and anxiety. Patients who have an introverted, instable, nervous temperament are more likely to be depressed and anxious. Psychological assessment intervention and therapy should be carried out as early as possible.
