Psychoemotional response and quality of life of patients with rheumatoid arthritis: the relationship with alexithymia

Abstract

Annotation. In aim to study the features of the psycho-emotional response and quality of life of rheumatoid arthritis (RA) patients in the context of alexithymia, 146 RA patients were examined using the DAS-28, SDAI, CDAI, VAS, HAQ, DRI, TAS-20, HDRS, HARS, A. Beck and SF-36. RA patients showed signs of mild depression (HRDS score 9.59±7.09 points, A. Beck scale 10.04±15.00 points), and alexithymia patients showed signs of depression of moderate severity (16.72±5.79 points and 17.31±14.60 points), and in patients without alexithymia – subdepression (7.25±5.82 points and 7.66±14.41 points); and increased level of anxiety (HARS score 17.07±7.08 points), while patients with alexithymia had a significantly higher score compared to patients without alexithymia (20.08±5.86 points versus 16.08±7, 19 points, p<0.01). Correlations of moderate strength were established between depression and anxiety and clinical symptoms of the disease; moreover, in patients with alexithymia, these connections were distorted, which gives reason to consider alexithymia as a factor that distorts pathophysiological and psychopathological reactions, and distorts the connections between somatic and psychological factors in the pathogenesis of RA. In patients with RA, a decrease in quality of life was found, more significant in patients with alexithymia, according to the physical component of health (indicators in all patients 53.05±19.36 points, in patients with alexithymia 35.69±14.19 points, without alexithymia – 58.73±17.38 points, p<0.001) and the psychological component of health (57.84±18.02 points, 34.78±8.79 points and 65.38±13.19 points, respectively, p<0.001). Significant (p<0.001) inverse correlations of mainly moderate quality of life with indicators of RA activity, severity of pain syndrome, functional capacity and health status of patients, as well as with TAS-20 indicators, depression and anxiety scales in patients without alexithymia, and the absence of significant relationships for most indicators in patients with alexithymia, which indicates that alexithymia distorts the influence of clinical and psychological factors on the quality of life of patients with RA.