AB0360E SLEEP DISORDER OR DEPRESSION IN KOREAN RHEUMATOID ARTHRITIS, AND ITS ASSOCIATION WITH DISEASE ACTIVITY

Abstract

Background Rheumatoid arthritis is a chronic autoimmune disease. Psychological stress and mood disorders such as sleep disorder or depression are more frequent in patient with RA. Objectives The aim of this study was to evaluate the relationship between disease activities and sleep disorder or depression in Korean patients with RA. Methods The study enrolled 334 patients with RA who visited Hallym University Sacred Heart Hospital (South Korea). The diagnosis of insomnia and depression is based in patient questionnaire such as Pittsburg sleep quality index (PSQI) and Beck depression inventory (BDI). Insomnia was defined as PSQI>5 and depression was defined as BDI ≥13. Patients were divided into two groups (insomnia vs no-insomnia, depression vs no-depression) and the clinical aspects were compared by Mann-Whitney U-test. Age, gender, erythrocyte sedimentation rate (ESR), 28 joint disease activity score (DAS28), DAS28-P score (the subjective components of the DAS28 relative to the total components), tender joint count (TJC) and swollen joint count (SJC), quality of life measured with health assessment questionnaire (HAQ) were analyzed. Results The median (inter-quartile range) disease duration was 6 (4–9) years and the mean DAS28 score was 3.6±1.1. Seventy percent of the patient had insomnia and 8% had depression. Compared with patients without insomnia, insomnia patients had a higher DAS28 (3.7±1.16 vs. 3.21±1.0, P On univariable logistic regression analysis, insomnia was positively associated with age, DAS28, DAS28-P and BDI score. After adjustment, insomnia was positively associated with sex (female), age, BDI and DAS28 score. On univariable logistic regression analysis, depression was positively associated with PSQI, DAS28 and DAS28-P score. After adjustment, depression was positively associated with PSQI and DAS28-P score. Conclusion Rheumatoid arthritis patient with the sleep disorder or depression had worse clinical symptoms than those without. Rheumatologist should take sleep disorder or depression into consideration on evaluation of disease severity in RA patients. Disclosure of Interests None declared