Hospital Anxiety and Depression Scale Score Is an Independent Factor Associated With the EuroQoL 5-Dimensional Descriptive System in Patients With Rheumatoid Arthritis


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Abstract

ObjectiveThis study aimed to examine anxiety and depression experienced by patients with rheumatoid arthritis (RA) using EuroQoL 5-Dimensional Descriptive System (EQ-5D) and Hospital Anxiety and Depression Scale (HADS) scores.MethodsWe analyzed 1005 Japanese patients with RA. Stepwise multiple linear regression analysis was performed to evaluate the independent influence of variables on EQ-5D and HADS scores. Pearson correlation coefficients were also calculated to explore relationships between variables.ResultsThe mean EQ-5D score was 0.74 for all patients (mean age, 63.2 years; mean disease duration, 13.6 years; mean Health Assessment Questionnaire Disability Index [HAQ-DI], 0.78; mean HADS total [HADS-T] score, 10.3; mean disease activity score assessed by 28 joints based on CRP [DAS28-CRP], 2.8). The EQ-5D score was strongly correlated with HAQ-DI and was moderately correlated with age, Steinbrocker functional class, HADS-T score, tender joint count assessed by 28 joints, pain on a visual analog scale (pain-VAS), patient's global assessment of disease activity (general-VAS), and DAS28-CRP. The HADS-T score was moderately correlated with HAQ-DI, pain-VAS, general-VAS, and DAS28-CRP. Factors that influenced the EQ-5D score included HAQ-DI (β = −0.533), pain-VAS (β = −0.128), HADS-T score (β = −0.142), DAS28-CRP (β = −0.187), and prednisolone use (β = −0.056). Factors that influenced the HADS score included HAQ-DI (β = 0.348), general-VAS (β = 0.145), disease duration (β = 0.094), and worklessness (β = 0.083).ConclusionsThe HADS score is an independent factor associated with EQ-5D in patients with RA. Our findings suggest that the assessment of anxiety and depression is essential in achieving better quality of life for patients with RA.

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