PMS15 - Psychological Distress In Chinese Patients With Rheumatoid Arthritis And Psychometric Validation Of Chinese Hospital Anxiety And Depression Scale

Abstract

To validate the psychometric properties of Chinese Hospital Anxiety and Depression Scale (HADS) and investigate the psychological distress in patients with Rheumatoid Arthritis (RA) in Mainland China. The psychometric properties of HADS were validated by interviewing subjects with questionnaires containing the HADS, EQ-5D, and SF-12. Reliability was assessed by Cronbach's alpha and construct validity by assessing a priori hypotheses. Prevalence of anxiety and depression were summarized by region and ACR classification according to HADS scale cut-off values. Potential factors related to co-morbidities were analysed by fitting two mixed models Questionnaires were administered to a consecutive sample of 133 RA patients. Regarding the validation of HADS, Cronbach's alpha showed a strong reliability among all the items, achieving 0.872 for the anxiety subscale and 0.788 for the depression subscale. Construct validity was supported by achieving both a priori hypotheses based on correlations between the HAQ scores and scales of EQ-5D and SF-12. About the prevalence of psychological distress, majority of RA patients showed either doubtful (15.8%) or definite (38.3%) anxiety; and with doubtful (26.3%) or definite (36.1%) depression. Physical function loss due to RA was tested to be a significant factor for both anxiety and depression (P<0.05). The results are generally consistent between subgroups from north and south China. The Chinese version of HADS demonstrated good patient acceptability and psychometric properties (including internal consistency reliability, and construct validity) in RA patients from north and south of China supporting its use for routine screening in Chinese RA patients. Prevalence of psychological distress in Chinese RA patients, especially the ones with severe physical function loss due to RA, is high and need more efforts of screening and intervention.