The Relationship Between Pain And Anxiety And Depression In Patients With Rheumatoid Arthritis

Objective: This study mainly investigated the incidence of anxiety and depression in patients with rheumatoid arthritis,and explored the relationship between pain and anxiety and depression in patients with rheumatoid arthritis.Methods: The study was conducted from November 2021 to September 2022.The subjects were 271 patients with rheumatoid arthritis who attended the outpatient clinic of an expert in rheumatology and immunology at a third-class hospital.General data of patients,such as gender,age,education level,family economic status,activity restriction degree,etc.,were collected by self-made scale.Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)were used to evaluate the anxiety and depression status of the patients,and then the patients were divided into a group without anxiety(HAMA<14)and a group with anxiety(HAMA≥14),a group without depression(HAMD<17)and a group with depression(HAMD≥17).The simple Mc Gill Pain Questionnaire(SF-MPQ)was used to assess patients’ pain intensity,including the affective pain rating index(A-PRI),visual analog scale(VAS),and existing pain intensity(PPI).The pressure pain threshold(PPT)was determined by electronic pain meter.And t test,Chi-square test,Spearman correlation analysis and binary logistics regression were used to analyze the data.Results:(1)The incidence of anxiety and depression in 271 patients with rheumatoid arthritis was 29.5% and 34.7%,respectively.(2)In patients with rheumatoid arthritis,there were differences between the without anxious group and the with anxious group in age,education level,family economic conditions,activity restriction degree,A-PRI,VAS,PPI and PPT.There were differences in age,educational level,family economic condition,religious belief,life satisfaction,duration of disease,activity limitation,A-PRI,VAS,PPI and PPT between the without depressed group and the with depressed group.(3)The differences in anxiety、depression and pain between men and women were compared according to gender groups,and it was found that there were differences only in PPT between men and women.(4)Analysis of relevant factors showed that the total scores of HAMA and HAMD were significantly correlated with A-PRI,VAS,PPI and PPT.(5)Binary logistic regression analysis showed that patients with rheumatoid arthritis were more prone to anxiety with the increase of age and A-PRI.The risk factors for depression were older age,poor family economic conditions,low life satisfaction,severe activity limitation,increased A-PRI number and severe existing pain status.Conclusion: Patients with rheumatoid arthritis have a high incidence of anxiety and depression,and most of them are elderly,low educational level,poor family economy,low life satisfaction,long duration of disease and severe activity restriction.In addition,older age,higher pain intensity and lower pain threshold were risk factors for anxiety.Older age,poor family economic conditions,low life satisfaction,severe activity restriction,high pain intensity are the risk factors for depression.