Influence of successful psychopharmacotherapy of anxiety-depressive spectrum disorders on the severity of chronic fatigue in patients with rheumatoid arthritis
- Authors: Abramkin A.A.1, Lisitsyna T.A.1, Veltishchev D.Y.2,3, Seravina O.F.4, Kovalevskaya O.B.4, Glukhova S.I.1, Nasonov E.L.1,5
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Affiliations:
- Nasonova Research Institute of Rheumatology
- Moscow Research Institute of Psychiatry – branch of the Serbsky National Medical Research Center of Psychiatry and Narcology, Moscow, Russia
- Pirogov Russian National Research Medical University
- Moscow Research Institute of Psychiatry – branch of the Serbsky National Medical Research Center of Psychiatry and Narcology
- Sechenov First Moscow State Medical University (Sechenov University)
- Issue: Vol 93, No 5 (2021)
- Pages: 551–560
- Section: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/71506
- DOI: https://doi.org/10.26442/00403660.2021.05.200786
- ID: 71506
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Abstract
Aim. To assess the influence of psychopharmacotherapy (PPT) of anxiety and depressive disorders on fatigue severity in patients with rheumatoid arthritis (RA).
Materials and methods. 128 RA-patients were included. Severity of fatigue was measured with fatigue severity scale (FSS), clinically important fatigue was diagnosed in patients with FSS≥4. Anxiety and depressive disorders (ADD) were diagnosed by a licensed psychiatrist in 123 (96.1%) of RA-patients in accordance with ICD-10 in semi-structured interview. Severity of depression and anxiety was evaluated with Montgomery–Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Rating Scale (HAM-A). RA-patients with ADD were divided into the following treatment groups: 1 – сDMARDs (n=39), 2 – сDMARDs+PPT (sertraline or mianserine), n=43, 3 – сDMARDs+bDMARDs (n=32), 4 – сDMARDs+bDMARDs+PPT (sertraline or mianserine), n=9. Biologics treatment duration varied from 1 to 5 years, antidepressants – from 6 to 96 weeks. 83 (67.5%) RA patients were assessed at five-years follow-up. Multinominal logistic regression analysis was conducted to determine factors associated with clinically important fatigue.
Results. Multinominal logistic regression analysis showed clinically important fatigue at baseline to be positively associated (OR 13.57; 95% CI 3.044–60.486; p=0.01) and remission of ADD – negatively associated (OR 0.162; 95% CI 0.032–0.809; p=0.027), with clinically important fatigue at 5 years follow-up (R2=0.385, p<0.0001).
Conclusion. Due to significant relationship between mental health status, antidepressants treatment and clinically important fatigue in RA-patients, all patients reporting clinically important fatigue should be recommended mental health counselling by a licensed psychiatrist.
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##article.viewOnOriginalSite##About the authors
Anton A. Abramkin
Nasonova Research Institute of Rheumatology
Email: 79096237832@ya.ru
ORCID iD: 0000-0002-1504-5645
врач-ревматолог
Russian Federation, MoscowTatiana A. Lisitsyna
Nasonova Research Institute of Rheumatology
Email: 79096237832@ya.ru
ORCID iD: 0000-0001-9437-406X
вед. науч. сотр. лаб. сосудистой ревматологии
Russian Federation, MoscowDmitrii Y. Veltishchev
Moscow Research Institute of Psychiatry – branch of the Serbsky National Medical Research Center of Psychiatry and Narcology, Moscow, Russia; Pirogov Russian National Research Medical University
Email: 79096237832@ya.ru
ORCID iD: 0000-0001-5210-2605
рук. отд-ния психических расстройств при соматических заболеваниях МНИИП – филиала ФГБУ «НМИЦ ПН им. В.П. Сербского», проф. каф. психиатрии ФДПО ФГАОУ ВО «РНИМУ им. Н.И. Пирогова»
Russian Federation, Moscow; MoscowOlga F. Seravina
Moscow Research Institute of Psychiatry – branch of the Serbsky National Medical Research Center of Psychiatry and Narcology
Author for correspondence.
Email: 79096237832@ya.ru
ORCID iD: 0000-0001-5839-4637
науч. сотр. отд-ния психических расстройств при соматических заболеваниях
Russian Federation, MoscowOksana B. Kovalevskaya
Moscow Research Institute of Psychiatry – branch of the Serbsky National Medical Research Center of Psychiatry and Narcology
Email: 79096237832@ya.ru
ORCID iD: 0000-0001-6573-4337
науч. сотр. отд-ния психических расстройств при соматических заболеваниях
Russian Federation, MoscowSvetlana I. Glukhova
Nasonova Research Institute of Rheumatology
Email: 79096237832@ya.ru
ORCID iD: 0000-0002-4285-0869
cт. науч. сотр. лаб. медико-социальных проблем ревматологии
Russian Federation, MoscowEvgeny L. Nasonov
Nasonova Research Institute of Rheumatology; Sechenov First Moscow State Medical University (Sechenov University)
Email: nasonov@irramn.ru
ORCID iD: 0000-0002-1598-8360
акад. РАН, д-р мед. наук, проф., науч. рук. ФГБНУ «НИИ ревматологии им. В.А. Насоновой», проф. ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова»
Russian Federation, Moscow; MoscowReferences
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