海南地区类风湿关节炎患者焦虑抑郁状态及其影响因素调查

Investigation on anxiety and depression of patients with rheumatoid arthritis in Hainan and its influencing factors

目的调查海南地区类风湿关节炎(RA)患者焦虑抑郁情绪状态及其相关影响因素,为RA患者的心理干预治疗提供客观依据。方法选取2019年1月至2020年6月期间在海南医学院第一附属医院风湿免疫科治疗的197例RA患者为研究对象。采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评估患者的焦虑抑郁情绪,采用临床疾病活动指数(CDAI)评定患者的疾病活动度,采用Pearson检验分析RA患者焦虑、抑郁情绪与疾病活动度的相关性。收集患者基本信息和临床资料,采用Logistic回归模型分析RA患者焦虑、抑郁情绪的影响因素。结果 197例RA患者中焦虑、抑郁的发生率分别为41.4%、22.8%;合并焦虑和抑郁情绪的患者CDAI评分明显高于无焦虑和无抑郁情绪患者,差异均有统计学意义(P<0.05);RA患者SAS得分、SDS得分均与CDAI评分呈正相关性(r=0.327、0.411,P<0.05);单因素分析结果显示,RA患者产生焦虑情绪与年龄、职业、文化程度、居住环境、年收入、医疗支出方式有关(P<0.05),RA患者产生抑郁情绪与年龄、文化程度、年收入、医疗支出方式有关(P<0.05);Logistic多因素分析结果显示,年龄<55岁、年收入<5万、无业是导致RA患者产生焦虑情绪的独立危险因素(P<0.05);年龄<55岁、年收入<5万是引发RA患者产生抑郁情绪的独立危险因素(P<0.05)。结论海南地区RA患者存在一定程度的焦虑抑郁状态,其发病因素包括病情负担、年龄、经济负担等,临床应当重视RA患者负面情绪的影响因素,进行针对性的干预治疗。

Objective To investigate the anxiety and depression of patients with rheumatoid arthritis(RA)in Hainan Province and its influencing factors,so as to provide objective basis for psychological intervention of RA patients.Methods From January 2019 to June 2020,197 RA patients who were treated in Department of Rheumatology and Immunology,the First Affiliated Hospital of Hainan Medical College were selected as the research objects.Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to evaluate patients'anxiety and depression.Clinical disease activity index(CDAI)was used to evaluate disease activity.Pearson test was used to analyze the correlation between anxiety,depression,and disease activity in RA patients.The basic information and clinical data of RA patients were collected.Logistic regression model was used to analyze the influencing factors of anxiety and depression in RA patients.Results The incidence of anxiety and depression in 197 RA patients were 41.4%and 22.8%,respectively.The CDAI score of RA patients with anxiety and depression was significantly higher than that of RA patients without anxiety and depression(P<0.05).SAS score and SDS score were positively correlated with CDAI score(r=0.327,0.411,P<0.05).Univariate analysis showed that anxiety of RA patients was related to age,occupation,education level,living environment,annual income and medical expenditure mode(P<0.05),while depression was related to age,education level,annual income and medical expenditure mode(P<0.05).Logistic multivariate analysis showed that age<55 years old,annual income<50000,unemployment were the independent risk factors of anxiety in RA patients(P<0.05),while age<55 years old and annual income<50000 were the independent risk factors of depression in RA patients(P<0.05).Conclusion There is a certain degree of anxiety and depression in RA patients in Hainan Province.The incidence factors include disease burden,age,economic burden,and so on.Clinicians should pay attention to the influencing factors of RA patients'negative emotions and carry out targeted intervention treatment.