Abstract | Cilj istraživanja:
Usporediti stupanj depresije i anksioznosti u bolesnika oboljelih od reumatoidnog
artritisa, sistemskog lupusa i sistemske sklerodermije, te im utvrditi povezanost duljine trajanja
upalnih reumatskih bolesti i laboratorijskih vrijednosti upalnih parametara sa pojavom simptoma
anksioznosti i depresije.
Materijali i metode:
U istraživanje je uključeno 106 ispitanika sa RA, 60 ispitanika sa SLE i 27 ispitanika sa
SSc kojima je dijagnozu postavio licencirani reumatolog. Nakon uzete anamneze (gdje se dobio
podatak o duljini trajanja bolesti) i obavljenog kliničkog pregleda, ispitanici su pristupili
ispunjavanju BDI i BAI. S obzirom na rezultat anketa, napravljena je kategorizacija ispitanika
na: bez, blago, umjereno i teško depresivne/anksiozne. Referentne vrijednosti za ankete dobivene
su kod psihologa zaposlenih na Klinici za psihijatriju, KBC-a Split. Vrijednosti sedimentacije i
CRP-a su analizirane naknadno, direktnim uvidom u laboratorijske nalaze ili pregledom
medicinske dokumentacije ispitanika. U Microsoft Office Excell programu za Windows su
izračunate aritmetičke sredine i standardne devijacije, te medijan i rasponi vrijednosti za
varijable koje su se koristile u istraživanju. Daljnja statistička obrada obavljena je u programu
Statistica 11.
Rezultati:
Najviši medijan vrijednosti BDI-a je zabilježen u oboljelih od SSc i iznosi 13. Dokazana
je statistički značajna razlika u pojavnosti simptoma depresije između oboljelih od RA i SLE
(p=0.005), te između SLE i SSc (p=0.044). Vrijednosti medijana BAI-a su približno iste u sve tri
ispitivane bolesti i iznose za RA 14, za SLE 13 i za SSc 13. Prosječno trajanje bolesti je
podjednako u ispitanika oboljelih od RA (13.24 g.) i SLE (12.87 g.), dok je nešto kraće u
oboljelih od SSc (10.74 g.). Najviši medijan vrijednosti SE i CRP-a imaju ispitanici kojima je
dijagnosticiran RA, (SE 25mm/h, CRP 11.7mg/L), a najniži oboljeli od SLE (SE 15mm/h, CRP
4.7mg/L).
Zaključci:
Stupanj depresije je najizraženiji u oboljelih od SSc, naspram RA i SLE. Razina
anksioznosti je podjednaka u svim istraživanim bolestima. Nije potvrđena povezanost između
duljine trajanja bolesti i stupnja anksioznosti i depresije, kao ni povezanost vrijednosti
laboratorijskih upalnih parametara sa pojavom depresije i anksioznosti u istraživanim bolestima. |
Abstract (english) | Objectives:
To compare the degree of depression and anxiety in patients suffering from rheumatoid
arthritis, systemic lupus erythematosus and systemic scleroderma, also to determine the
relationship between the duration of rheumatic diseases and the appearance of symptoms of
anxiety and depression, and to determine the relationship between laboratory values of
inflammatory parameters and the appearance of symptoms of anxiety and depression in patients
treated at the Department of Rheumatology and Clinical Immunology, University Hospital Split.
Patients and methods:
The study included 106 patients with RA, 60 patients with SLE and 27 patients with SSc.
All patients were diagnosed by a qualified rheumatologist. After anamnesis (where we got the
information about the duration of the disease) and clinical examination, respondents access the
fulfillment of the BDI and BAI. According to the results of the questionnaire, respondents were
categorizated in the: no, mild, moderate, and severe depression / anxiety group. Reference values
for the surveys were obtained from the psychologists employed at the Department of Psychiatry,
University Hospital of Split. The erythrocyte sedimentation rates and values of CRP were
analyzed subsequently, whether by direct inspection of the laboratory findings, or review of
medical documents of subjects. The mean and standard deviation, and the median and range of
values for the variables that were used in the study were calculated in Microsoft Office Excel
program for Windows. Further statistical analysis was performed in program Statistica 11.
Results:
The highest median BDI is found in patients with SSc (13). There is statistically
significant difference in the prevalence of depressive symptoms among patients with RA and
SLE (p=0.005), and between SLE and SSc (p=0.044). Median values of BAI are approximately
the same in all three diseases (14 for RA, 13 for SLE and 13 for SSc). Average disease duration
is the same for the patients suffering from RA (13.24 years) and SLE (12.87 years), while it is a
little bit shorter in patients with SSc (10.74 years). The highest median values of ESR and CRP
are in subjects with RA (ESR 25 mm/h, CRP 11.7 mg/L), and the lowest in patients suffering
from SLE (ESR 15 mm/h, CRP 4.7 mg/L).
Conclusions:
The degree of depression was the highest in patients with SSc, compared with RA and
SLE. The level of anxiety was similar in all three studied diseases. The relationship between
disease duration and degree of anxiety and depression, as well as correlation between values of
inflammatory laboratory parameters and the symptoms of depression and anxiety in the
investigated diseases was not confirmed. |