류마티스 관절염 환자의 질병상태, 통증, 및 우울의 인과성 탐색

Abstract

To investigate the relationships among disease activity, pain, and depression, 79 of newly diagnosed RA patients were examined before and after the 3-month treatment. Forty eight percent of the subjects dropped out from the study during the second data collection period. Three dimensions (ESR, pain, and depression) were assessed before and after the 3-month treatment period, ESR(p=.001), pain(p=.004), depression(p=.007) were improved significantly after 3-month of treatment. Level of Hemoglobin was not changed during the study period. The following 6 specific hypothesis were tested. For the convenience of analysis, subjects were grouped into 3 categories, high-high, high-low, and low-low groups in each of three dimensions (ESR, Depression, and pain). The first high-high group is those reported high scores in ESR both before and after the treatment: the high-low group is those reported high ESR scores before and low ESR scores after the treatment and lastly: the low-low group is those with low ESR scores both before and after treatment. 1. The hypothesis, "Those low-low group, high-low group and high-high group in ESR will be different in pain and depression after the treatment" was rejected. 2. The hypothesis, "Those low-low group, high-low group and high-high group in depression will be different in pain after the treat" was supported(p=.008). 3. The hypothesis, "Those low-low group, high-low group, and high-high group in depression will be different in ESR after the treat" was rejected. 4. The hypothesis, "The low-low group, high-low group, and high-high group in pain will be different in depression after the 3-month treatment" was supported(p=.006). Conclusively, pain and depression were showed a reciprocal relationships each other, so it would have difficulties to identify causal relationships in chronic patients with rheumatoid arthritis having both pain and depression at the same time. Further time series study with newly found patients with arthritis will be recommended in order to identify the pure causality.