The impact of psychiatric disorders on quality of life in patients with rheumatoid arthritis

Objective: In recent years, the relationship between quality of life (QoL) and mental disorders in subjects with medical illnesses has been acquiring more importance. The present study was designed to examine the effects of psychiatric disorders on QoL in patients with rheumatoid arthritis (RA). Methods: The study was carried out among patients with RA who admitted to rheumatology outpatient clinic of department of physical medicine and rehabilitation of an university hospital. The study sample included 30 RA outpatients with axis I psychiatric disorder, 30 RA outpatients and 30 healthy subjects without any axis I psychiatric disorder. The psychiatric disorders were determined by means of the Structured Clinical Interview for DSM-IV. To determine the participants' QoL levels, we used the World Health Organization QoL Assessment-Brief (WHOQOL-BREF). Disease activity for RA was assessed with the Disease Activity Score. Results: Most of patients with RA were women, and they were mostly taking medications such as non-steroid anti-inflammatory drugs, corticosteroids, and metothrexate. Of RA patients with psychiatric disorders, 50% (15) had only depressive disorders, and 20% (6) had only anxiety disorders. The study groups had similar features with respect to age, sex, educational level, and marital status. There was no significant difference for treatments, disease duration and disease activity between RA patients with and without axis I psychiatric disorder. The QoL levels of all domains were lowest in RA patients with a psychiatric diagnosis. In addition, RA patients without psychiatric disorder had significantly lower scores of WHOQOL-BREF compared to healthy controls. Conclusion: The study results suggest that patients with RA have poorer QoL levels, and that psychiatric disorders appear to be a considerable factor affecting QoL of patients with RA. (Anatolian Journal of Psychiatry 2009; 10: 94-99)