Avaliação da fadiga em pacientes com artrite psoriásica e sua correlação com índice de qualidade de vida, sintomas de ansiedade e depressão e atividade de doença

Abstract

Chronic inflammatory diseases are associated with significant psychosocial morbidity and a decrease in health-related quality of life causing disabilities and fatigue. Psychiatric comorbidity, often found in dermatologic patients, also plays an important role on the impairment of quality of life and fatigue The aim of this study is to to assess the prevalence of fatigue on patients with psoriatic arthritis of specific ambulatories of HUCFF/UFRJ and HUPE/UERJ and to correlate it to quality of life indices, function, anxiety and depression and activity of the disease. This is a cross-sectional study performed on outpatient clinic patients older than 18 years-old. The Fatigue Assessment of Chronic Illness Therapy Scale (FACIT F) was used to measure the fatigue; The Health Survey-36 (SF-36) by the Psoriasis Disability Index (PDI) to measure the quality of life; the Health Assessment Questionnaire (HAQ), to function; the Hospital Anxiety and Depression Scale (HAD) to measure anxiety and depression symptoms Psoriasis Area and Severity Index (PASI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI and Clinical Disease Activity Index (CDAI) to evaluate the clinical activity. 101 patients (57 male and 44 female) with mean age of 50, 77 were evaluated and answered the questionnaires. The mean PDI score was 8.01; the PASI score, 9.88; the BASDAI score, 3.59; the HAQ score, 0.85; the HAD A score, 7.39; the HAD D score, 5.93, the FACIT F score, 38.3 and the CDAI, score, 2. 65. FACIT_F was statically associated with PASI (rs-0,345, p<0.001), PDI (rs-0,299, p<0.002); HAQ (rs-0.460); HAD A (rs-0,306); HAD D (rs -0,339). There was statistically significant correlation with all of the domains of SF-36 and FACIT IV. There was not correlation with CDAI or BASDAI. There was a prevalence of fatigue from moderate to intense in less than 25% of patients with psoriatic arthritis. Fatigue seems to be more related to the emotional and social aspects of the disease rather than to the joint inflammatory aspects proper, confirming that the disease s visibility is the most disturbing aspect for the patient and that skin pain" is more intense than the joint pain.