Illness perceptions and psychological distress associated with physical health-related quality of life in primary Sjogren's syndrome compared to systemic lupus erythematosus and rheumatoid arthritis
Illness perceptions and psychological distress associated with physical health-related quality of life in primary Sjogren's syndrome compared to systemic lupus erythematosus and rheumatoid arthritis
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DOI：
10.1007/s00296-014-3008-0
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发表时间：
2014-12-01
影响因子：
4
通讯作者：
Hyphantis, Thomas
中科院分区：
文献类型：
--
作者：
Kotsis, Konstantinos;Voulgari, Paraskevi V.;Hyphantis, Thomas
尽管心理困扰和疾病的看法是重要的，在确定结果的风湿性疾病，很少有研究调查这些变量在原发性干燥综合征（pSS）。本研究旨在比较pSS、系统性红斑狼疮（SLE）和类风湿性关节炎（RA）患者的疾病感知和心理困扰，并检验这些患者与健康相关生活质量（HRQoL）的相关性是否相似。在57例pSS患者、75例SLE患者和199例RA患者中，我们使用患者健康问卷（PHQ-9）、症状检查表和简明疾病感知问卷评估心理变量，并使用世界卫生组织生活质量量表简表评估HRQoL。分层回归模型确定了调整人口统计学变量和临床参数后心理变量与HRQoL的相关性。临床上显著的抑郁症状（PHQ-9a/千日元10）的患病率在pSS中为24.6%，在SLE中为29.3%，在RA中为25.1%。与其他患者组相比，pSS患者对自己的疾病（可理解性）了解甚少，并将更多症状归因于自己的疾病（身份）。在所有三组中，疾病感知和抑郁症状与身体HRQoL以相似的模式独立相关。然而，在pSS中，患者对疾病后果的担忧与身体HRQoL的相关性比疼痛更强。这些研究结果表明，心理因素是重要的相关HRQoL在这些疾病组，并鼓励设计心理教育疗法，针对疾病相关的认知在pSS，试图改善患者的身体HRQoL。
Notwithstanding that psychological distress and illness perceptions are important in determining outcomes in rheumatic diseases, few studies investigated these variables in primary Sjogren's syndrome (pSS). We aimed to compare illness perceptions and psychological distress in patients with pSS, systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) and to test whether their associations with health-related quality of life (HRQoL) are similar in these groups of patients. In 57 patients with pSS, 75 with SLE and 199 with RA, we administered the Patient Health Questionnaire (PHQ-9), the Symptom Check-List and the Brief-Illness Perception Questionnaire to assess psychological variables and the World Health Organization Quality of Life Instrument, Short-Form to assess HRQoL. Hierarchical regression models determined the associations of psychological variables with HRQoL after adjusting for demographic variables and clinical parameters. The prevalence of clinically significant depressive symptoms (PHQ-9 a parts per thousand yen 10) was 24.6 % in pSS, 29.3 % in SLE and 25.1 % in RA. Patients with pSS showed little understanding of their disease (comprehensibility) and attributed more symptoms to their illness (identity) compared with the other groups of patients. Illness perceptions and depressive symptoms were independently associated with physical HRQoL in a similar pattern in all three groups. In pSS, however, the patients' worries about the consequences of their illness was a stronger correlate of physical HRQoL than pain. These findings indicate that psychological factors are important correlates of HRQoL in these disease groups and encourage the design of psycho-educational therapies targeting disease-related cognitions in pSS in an attempt to improve patient's physical HRQoL.