The prevalence of mood disturbances such as anxiety and depression is greater in rheumatoid arthritis (RA) patients than in the general population. Given this association, the primary aim of this study was to assess the incremental impact of anxiety or depression on patients with RA from the United States of America (USA) and Europe, independent of the impact of the underlying RA disease. Rheumatologists (n = 408) from the USA and 5 European countries completed patient record forms for a predetermined number of RA patients who consulted consecutively during the study period; these patients completed patient-reported questionnaires. Descriptive statistics and multivariate regression were used to investigate the relationship between anxiety and depression with treatment and economic outcomes in RA patients. Of 1015 physician and patient pairs who completed all relevant questionnaire sections, 390 (38.4%) patients self-reported anxiety or depression, while 180 (17.7%) patients were reported to have anxiety or depression by their physicians. Controlling for age, gender, body mass index and clinical factors (flaring and severity), multiple regression analyses suggested that patients with anxiety or depression more often experienced treatment dissatisfaction (odds ratio [OR] 2.28; P < .001), had greater impairment in work (coefficient [β] = 11.82; P = .001) and usual activity (β = 14.73; P < .001), greater disability (β = .35; P < .001), and more often reported unemployment (OR 1.74; P = .001). Multinomial logistic regression revealed discordance between physician and patient satisfaction with treatment. For patients reporting anxiety or depression, physicians were more often satisfied with achievement of current disease control than patients (relative risk ratio 2.19; P = .002). Concomitant anxiety or depression was associated with a significant incremental impact on the health-related quality of life and economic aspects of life of patients with RA. In light of observed differences between physician recognition of patient anxiety and/or depression versus patient reporting of anxiety and/or depression symptoms, further research is warranted to develop optimal screening and management of depression and anxiety in patients with RA.

中文翻译：

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焦虑和抑郁对类风湿关节炎患者的多方面影响

类风湿关节炎 (RA) 患者中焦虑和抑郁等情绪障碍的患病率高于一般人群。鉴于这种关联，本研究的主要目的是评估焦虑或抑郁对美国和欧洲的 RA 患者的增量影响，独立于潜在 RA 疾病的影响。来自美国和 5 个欧洲国家的风湿病学家 (n = 408) 为在研究期间连续咨询的预定数量的 RA 患者填写了患者记录表；这些患者完成了患者报告的问卷。描述性统计和多变量回归用于研究 RA 患者焦虑和抑郁与治疗和经济结果之间的关系。在完成所有相关问卷部分的 1015 对医生和患者中，390 名（38.4%）患者自我报告焦虑或抑郁，而 180 名（17.7%）患者被医生报告患有焦虑或抑郁。控制年龄、性别、体重指数和临床因素（发作和严重程度），多元回归分析表明焦虑或抑郁患者更常经历治疗不满意（优势比 [OR] 2.28；P < .001），受损程度更大在工作（系数 [β] = 11.82；P = .001）和日常活动（β = 14.73；P < .001）、更大的残疾（β = .35；P < .001）和更经常报告的失业（或1.74；P = .001）。多项逻辑回归显示医生和患者对治疗的满意度之间存在不一致。对于报告焦虑或抑郁的患者，医生对当前疾病控制的成就比患者更满意（相对风险比 2.19；P = .002）。伴随的焦虑或抑郁与对 RA 患者健康相关生活质量和生活经济方面的显着增量影响有关。鉴于观察到医生对患者焦虑和/或抑郁的认识与患者报告的焦虑和/或抑郁症状之间的差异，有必要进一步研究以开发对 RA 患者抑郁和焦虑的最佳筛查和管理。伴随的焦虑或抑郁与对 RA 患者健康相关生活质量和生活经济方面的显着增量影响有关。鉴于观察到医生对患者焦虑和/或抑郁的认识与患者报告的焦虑和/或抑郁症状之间的差异，有必要进一步研究以开发对 RA 患者抑郁和焦虑的最佳筛查和管理。伴随的焦虑或抑郁与对 RA 患者健康相关生活质量和生活经济方面的显着增量影响有关。鉴于观察到医生对患者焦虑和/或抑郁的认识与患者报告的焦虑和/或抑郁症状之间的差异，有必要进一步研究以开发对 RA 患者抑郁和焦虑的最佳筛查和管理。