[Survey of quality of life of rheumatoid arthritis patients admitted to rehabilitation centres in Hungary]. / Hazai kórházakban rehabilitált rheumatoid arthritises betegek életminosége.

INTRODUCTION: There are limited data about the quality of life of rheumatoid arthritis patients admitted to rehabilitation centres in Hungary. AIM: The aim of the authors was to assess demographic data, social status, health related quality of life, and needs for assistance and disease-related information of 239 rheumatoid arthritis patients (169 women and 7 men) admitted to four rehabilitation centres in Hungary. METHOD: For the assessment of demographic, social and other data the authors developed questionnaires. The health related quality of life was evaluated using the validated Short Form 36 questionnaire. RESULTS: The authors found that rheumatoid arthritis patients require in-patient rehabilitation relatively early in their disease course. 80.4% of the patients were over 50 years of age, and their social status was low as compared to the average of the Hungarian population. The health related quality of life of patients was significantly lower than that of the average population, but it was similar to the quality of life of patients with osteoarthritis, osteoporosis and low back pain. Among domains of the quality of life, the scores for physical function and pain were the lowest. The most common accompanying diseases included hypertension and osteoporosis. In case of knee and hip surgeries, postoperative rehabilitation was performed in due time. Patients were not satisfied with disease-related information and education given by health care providers. CONCLUSIONS: There is poor quality of life of rheumatoid arthritis patients admitted to rehabilitation centres in Hungary. More efforts should be done to provide disease-related information and education for patients.

Psychosocial, educational, and somatic factors in chronic nonspecific low back pain.

Analysis of the effect of psychosocial factors and co-morbidities on the health status of patients with chronic nonspecific low back pain and patients with surgical intervention because of disk herniation was performed. One hundred and two nonselected consecutive inpatients with chronic nonspecific low back pain were included in the study. Their average age was 56.7 (SD = 10.9) years. The control group consisted of 199 subjects matched according to age and sex, chosen from the database of the national representative health survey Hungarostudy 2006, which involved 4,527 subjects. We measured quality of life including mental health with the SF-36 questionnaire validated for use in Hungary, the short 9-item version of the Beck Depression Inventory, the WHO-Five Well-Being Index, and the Hospital Anxiety-Depression Scale. We characterized the socio-demographic status with variables on age, sex, marital status, and education. Data on symptoms and signs of low back pain, other musculoskeletal diseases, and their treatments including spinal surgery were recorded. Co-morbidity and body mass index were considered as independent indicators of health. Depression as measured by Beck Depression Inventory and severity of depression did not vary significantly according to marital status, education, hypertension, diabetes, and gastrointestinal disease. Only half of the patients (52 %) were in the normal range of the scale; 22 % suffered from mild, 16 % from moderate, and 12 % from severe depression. Average values for anxiety and depression as measured by Hospital Anxiety-Depression Scale and Beck Depression Inventory were both significantly higher in the patient than in the control group (Hospital Anxiety Scale: p = 0.0001; Beck Depression Inventory: p = 0.0001). According to the WHO Well-Being Index-5 scale, the difference between patients and the control group was significant (p = 0.0001). Furthermore, correlation was found between the incidence of depression and surgery. Depression was demonstrated in 47.4 % of those patients who had no surgery, in 50 % of patients who had one round of surgery, and in 62.5 % of those who had undergone surgery more than once; the contingence coefficient was 0.211. According to different measurements, the psychological state of patients with chronic nonspecific low back pain was significantly altered as compared to the matched Hungarian population. Higher anxiety and depression markers occurred in 48 % of the patients. There was no correlation between the depression of patients with low back pain and variables such as marital status, education, and co-morbidities. Our study is the first to demonstrate that depression runs parallel with the number of surgical procedures. Therefore, if there is a relative indication for surgery, depression and severity of depression should be assessed and considered when deciding on the intervention.

[Quality of life of osteoporotic patients treated in rheumatology rehabilitation in-patient units]. / Reumatológiai rehabilitációs osztályokon kezelt osteoporosisos betegek életminosége.

UNLABELLED: There has been no report on demographic, social and quality of life data of osteoporotic patients attending rheumatology rehabilitation in-patient units in Hungary. AIM: The authors analyzed the data of osteoporotic patients treated in rheumatology rehabilitation departments as in-patients in four hospitals in Hungary. METHODS: Demographic and social data were obtained by using a questionnaire developed by the authors, and quality of life was assessed with the use of the SF-36 questionnaire. The quality of life data of osteoporotic patients were compared to that obtained from patients with rheumatoid arthritis, osteoarthrosis and chronic low back pain who were treated in the same department at the same time. RESULTS: Of the 253 patients who were asked to participate in the study, 211 patients filled out the questionnaires. 25.6% of the patients were male. 58% of the patients were younger than 60 years of age, and 40% of them were heavy physical workers earlier. More than 50% of the patients did not complete secondary school education, and only 6.7% of the patients had a per capita monthly income higher than 100 000 HUF. The quality of life of the osteoporotic patients assessed by SF-36 scored 34.7, which was significantly lower than that of the mean of the Hungarian population scoring 70-90. The SF-36 scores of osteoporotic patients were lower in all domains compared to the scores of patients with rheumatoid arthritis, osteoarthritis and low back pain, although the difference was significant only in the domain of physical activity. The affective role of patients with osteoporosis was significantly lower than those with rheumatoid arthritis and osteoarthritis. CONCLUSIONS: Osteoporotic patients attending in-patient rheumatology in-patient rehabilitation units in Hungary have poor quality of life comparable, even worse than that found in patients with rheumatoid arthritis, osteoarthritis and chronic low back pain.

Depressive symptoms in early rheumatoid arthritis: a comparative longitudinal study.

Our objective was to investigate symptoms of depression in early rheumatoid arthritis (eRA) patients, and follow them longitudinally during a 3-year prospective study of 73 Hungarian and 45 Austrian early rheumatoid arthritis patients. Compared to validated national population data, mild symptoms of depression were detected in Hungarian early rheumatoid arthritis patients, which were independent of corticosteroid use. In the Hungarian subgroup, the Beck Depression Inventory scores were found to be stable during follow-up. Except at the baseline visit, depressive symptoms and functional status, as measured by the Health Assessment Questionnaire, were correlated. Significant differences were detected between Austrian and Hungarian patients despite of their geographical and cultural proximity. The mean depression score was higher in the Hungarian when compared to the Austrian patients. Depression is an important feature of early rheumatoid arthritis. Studies assessing depression in rheumatoid arthritis patients must be based on validated national data of normal population.

The effect of the thermal mineral water of Nagybaracska on patients with knee joint osteoarthritis--a double blind study.

To study the effect of thermal mineral water of Nagybaracska (Hungary) on patients with primary knee osteoarthritis in a randomized, double-blind clinical trial, 64 patients with nonsurgical knee joint osteoarthritis were randomly selected either into the thermal mineral water or into the tap water group in a non-spa resort village. The patients of both groups received 30-min sessions of bathing, 5 days a week for four consecutive weeks. The patients were evaluated by a blind observer immediately before and at the end of the trial using Western Ontario and McMaster Osteoarthritis (WOMAC) indices and follow-up assessment 3 months later. Twenty-seven patients of the 32 patients who received thermal mineral water and 25 of the 32 of those treated with tap water completed the trial. The WOMAC activity, pain, and total scores improved significantly in the thermal mineral-water-treated group. The improvement remained also at the end of the 3-month follow-up. The WOMAC activity, pain, and total scores improved significantly also in the tap water group at the end of the treatment course, but no improvement was detected at the end of the 3-month follow-up period. The treatment with the thermal mineral water of Nagybaracska significantly improved activity, pain, and total WOMAC scores of patients with nonsurgical OA of the knee. Even after 3 months, significant improvement was observed compared to the scores before the treatment or to tap water treatment.