ABSTRACT
Objective: To determine the prevalence, correlates andindependent predictors of self-reported depression, anxietyand stress in Rheumatoid arthritis (RA) patients in Hospital Melaka.Methods: This was a cross-sectional survey usingconvenient sampling of 192 RA patients who attended theRheumatology Clinic outpatient appointment, HospitalMelaka from June 2013 to December 2013. Depression,Anxiety and Stress Scale (DASS21) questionnaire was usedto evaluate symptoms of depression, anxiety and stress. RAdisease activity was assessed using the DAS28-ESRformula. Functional status was assessed via the HealthAssessment Questionnaire Disability Index (HAQ-DI).Results: Out of 189 completed questionnaires, 46%(n=86)patients reported psychological distress symptoms, and25%(n=48) experienced more than one negative emotionalstates. The prevalence of depression, anxiety and stressamong our patients were 23.3%(n=44), 42.3%(n=80) and20.1%(n=38) respectively. There were significant positivecorrelations (p<0.05) between these psychologicalsymptoms with disease activity, number of tender joints,general health, pain and HAQ score. Age was inverselycorrelated with depression, anxiety and stress. Highernumber of swollen joints correlated positively withdepression but not with anxiety and stress. HAQ was theonly independent predictor for depression (Odds Ratio[OR]=2.07; 95%CI: 1.19 to 3.61) and anxiety (OR=1.81;95%CI: 1.1 to 3.0) whilst pain was found to be independentpredictor for stress (OR=1.04; 95%CI: 1.0 to 1.1).Conclusion: The incidence of depression and anxiety in ourMalaysian sample of RA patient was comparable to thatobserved in Caucasian populations. Functional status wasan independent predictor of depression and anxiety,whereas pain was an independent predictor of stress.