Κατεύθυνση Ρευματολογία - Μυοσκελετική Υγεία
Library of the School of Health Sciences

2019-10-03

2019

Rapsomaniki Panagiota

Δημήτριος Μπούμπας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Δημήτριος Βασιλόπουλος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κλειώ Μαυραγάνη, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ

Συχνότητα, βαρύτητα και επιπτώσεις του καταστροφικού πόνου (pain catastrophizing), στην έκβαση του νοσήματος και στην ποιότητα ζωής των ασθενών με ρευματικά φλεγμονώδη νοσήματα

English
Greek

Frequency, severity and effects of pain catastrophizing, disease progression and quality of life in patients with rheumatic inflammatory diseases

Catastrophizing is considered the pain in which patients perceive the actual pain as unbearable, ruminate constantly negative thoughts and feel desperate and helpless to handle their disease. Studies have shown that catastrophizing pain has a significant impact on the lives of patients with rheumatic diseaseas, it increases susceptibility to pain, inflammation, physical disability, fatigue, the frequency of visits to physicians, and can affect the efficacy of treatment. The purpose of this study was to investigate the frequency, severity and impact of catastrophic pain on disease and the quality of life of patients with rheumatic diseases for a prospective cohort study of 80 patients (25 RA, 25 SLE, 10 PSA, 10 AS, 10 Dermatomyositis - Vasculitis - CTD). Data were collected from the Rheumatology Outpatient Clinic of General University Hospital "ATTIKON" on Athens. All patients experienced ˃50mm pain in the visual analogue pain scale (0 – 100). Demographics, comorbidities, medication compliance, current treatment, and frequency of outpatient visits were examined. In addition, for the 50 patients with SLE (25) and RA (25) the disease activity with SLEDAI and DAS28 as well as the functional ability using HAQ-DI were examined. The Pain Catastrophizing Scale Score (Greek version) was used which consists of 13 questions and three rating scales of "rumination", "magnification" and "helplessness". The following scores were used for the evaluation of results: 0-14 (low), 15-25 (average), ≥26-52 (high). The 86.3% of the patients were women and the mean (± SD) age of all patients is 53.0 (± 11.9) years, with a mean disease duration of 5.8 (± 6.1) years. The 78% of all patients had clinically significant catastrophizing pain (> 26) and 57.5% very high catastrophizing score (35 – 52). The mean value of total catastrophizing pain (PCS) was 34.3 (± 12.7). There was no difference in mean values between the SLE and RA patients (37 and 38.4 respectively);33.8% of all patientswere diagnosed with depression and 35% had fibromyalgia under medication. Patients with depression (p = 0.23) and fibromyalgia (p = 0.002) had higher rates of catastrophizing pain at all rating scales with a statistically significant difference. No difference in PCS activity (mean low diseaseactivity 36.7 (± 9.4) and mean medium disease activity 37.4 (± 11.8), was found between SLE patients. In contrast patients with moderate / severe RA showed a statistically significant difference across all scales of pain catastrophizing compared to those with low disease activity 40.3 (± 7.1) and moderate disease activity 31.0 (±10.4). No differences in treatment medication and compliance were found. A statistically significant correlation was found in the frequency of unscheduled visits which were more than one in the three-months scheduled follow up visit; across all pain rating scales. We concluded that despite modern medication, patients with rheumatic diseases exhibit high rates of pain catastrophizing that are independent of disease activity in SLE but not in RA. Intervention aimed at psychological self-management of the disease may improve the quality of life of patients and limit physician visits.

Health Sciences

Pain catastrophizing, Rheumatic diseases, SLE, RA

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0

Yes

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https://pergamos.lib.uoa.gr/uoa/dl/object/2881973