Psychiatric disturbances in rheumatoid arthritis

ABSTRACT

To study the pattern of psychiatric syndromes that may accompany Rheumatoid arthritis [RA] and their relationship to disease activity, severity, pain and disability. Also, to find out the impact of stressful life events on the same parameters of the disease. The study comprised forty RA patients and 20 apparently normal controls. They were subjected to thorough medical history taking, clinical examination, laboratory investigations, disease activity, spread severity index, functional assessment with the Health Assessment Questionnaire Score, the Social Readjustment Rating Scale [SRRS] and identification of psychiatric disorders using the International Classification of Diseases [ICD,-10] symptom checklist for mental disorders. The prevalence of psychiatric disorders was significantly higher in RA patients than in the control group [p<0.05]. Depressive disorders were the most prevalent of these disorders. The Social Readjustment Rating Scale was significantly higher in RA patients than in the control group [p<0.001]. Also RA patients with psychiatric disorders were found to have higher SRRS than those not suffering from psychiatric disorders [p<0.05]. The stressful life events were found to have a strong impact on disease activity and pain in RA patients. Depression was the most common psychological disturbance associated with RA. This study highlights the role that the rheumatologist can play in the early detection of psychiatric disorders and psychiatric consultation in the proper time. In addition, it should be emphasized that the psychosocial effects of RA should always be put in mind and treated as a part of the illness