In veterans with RA, PTSD worsens disease activity

(HealthDay)—For U.S. veterans with rheumatoid arthritis (RA), a diagnosis of posttraumatic stress disorder (PTSD) is associated with worse patient-reported outcomes and tender joint counts, according to a study published online in the February issue of Arthritis Care & Research.

To examine the correlation between PTSD and RA disease activity among U.S. veterans, Ted R. Mikuls, M.D., M.S.P.H., of the University of Nebraska in Omaha, and colleagues conducted a longitudinal observational study involving 1,522 veterans with RA (mean age, 63 years; 91 percent men; 78 percent white). Patients were followed for a mean of three years.

The researchers found that 11.7 percent of patients had PTSD and 23.7 percent had other anxiety/depression diagnoses. Compared to patients with no psychiatric diagnosis, having a diagnosis of PTSD was associated with higher scores of self-reported pain, physical impairment, tender joint count, and worse global well-being. However, there was no significant difference for patients with and without PTSD with respect to swollen joint count, erythrocyte sedimentation rate, or Disease Activity Score in 28 joints. No differences were seen in any outcomes for patients with PTSD versus other anxiety/depression disorders.

"The presence of a PTSD diagnosis was independently associated with worse RA clinical status over an extended period of follow-up," the authors write. "Additional insights in this area may provide avenues for improved management of pain, physical functioning, and quality of life in a significant and growing proportion of RA patients."

The Veterans Affairs Rheumatoid Arthritis registry is partially supported by Abbott and Bristol-Myers Squibb.

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