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Suzuki M, Kojima T, Terabe K, Ohashi Y, Sato R, Kosugiyama H, Hasegawa J, Ohno Y, Nagai K, Ohnishi C, Sugiura H, Fujita H, Nagayoshi M, Kojima M, Asai S, Imagama S. Association between laughter, frailty, and depression in rheumatoid arthritis patients. Int J Rheum Dis 2024; 27:e15034. [PMID: 38287545 DOI: 10.1111/1756-185x.15034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/27/2023] [Accepted: 12/26/2023] [Indexed: 01/31/2024]
Abstract
OBJECTIVE This study aimed to determine whether there are associations between laughter, disease activity, frailty, and depression in rheumatoid arthritis (RA) patients. METHODS A total of 240 patients were included in this prospective cohort study on frailty in RA patients between March 2021 and June 2022. Patients were divided into the following four groups according to the frequency of laughter: "almost every day," "1-5 days per week," "1-3 days per month," and "never or almost never." Patient characteristics were compared among the four groups by analysis of variance. Factors associated with laughter were identified by multivariable logistic analysis. RESULTS The mean 28-joint Disease Activity Score using CRP was 1.91, with 70.7% of patients in remission and 12.6% in low disease activity. For the "almost every day" (42.5% of patients), "1-5 days per week" (40.0%), "1-3 days per month" (11.3%), and "never or almost never" (6.3%) groups, scores of the Kihon Checklist (KCL) for assessing frailty status were 3.5, 4.6, 7.3, and 8.1 (p < .001), respectively, and scores of the Beck Depression Inventory (BDI-II) were 8.4, 10.7, 15.1, and 16.5 (p < .001), respectively. Multivariable analysis revealed that KCL (OR: 0.81, 95% CI: 0.73-0.90) and BDI-II (OR: 0.91, 95% CI: 0.86-0.95) scores were independently associated with the frequency of laughter. CONCLUSION Frailty and depression were associated with laughter in RA patients with controlled disease activity. Interventions aimed at not only disease activity control but also frailty prevention may lead to a life filled with laughter.
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Affiliation(s)
- Mochihito Suzuki
- Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toshihisa Kojima
- Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Orthopedic Surgery, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
| | - Kenya Terabe
- Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshifumi Ohashi
- Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryo Sato
- Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hironobu Kosugiyama
- Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Junya Hasegawa
- Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yusuke Ohno
- Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Chinami Ohnishi
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideshi Sugiura
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hitomi Fujita
- Faculty of Health Sciences, Department of Rehabilitation, Nihon Fukushi University, Handa, Japan
| | - Mako Nagayoshi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masayo Kojima
- Department of Frailty Research, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- Nagoya City University, Graduate School of Medicine, Nagoya, Japan
| | - Shuji Asai
- Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Machin AR, Babatunde O, Haththotuwa R, Scott I, Blagojevic-Bucknall M, Corp N, Chew-Graham CA, Hider SL. The association between anxiety and disease activity and quality of life in rheumatoid arthritis: a systematic review and meta-analysis. Clin Rheumatol 2020; 39:1471-1482. [PMID: 31897960 DOI: 10.1007/s10067-019-04900-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/02/2019] [Accepted: 12/15/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES In people with rheumatoid arthritis (RA), mental health problems are common, but often not recognized or treated, contributing to increased morbidity and mortality. Most studies examining the impact of mental health problems in RA have focused on depression. We aimed to determine the association between anxiety, and disease activity and quality of life (QoL) in people with RA. METHODS A systematic review and meta-analysis were performed. A protocol was registered with PROSPERO (CRD2-17062580). Databases (Web of Science, PsycINFO, CINAHL, Embase, Medline) were searched for studies examining the association between anxiety and disease activity and QoL, in adults with RA, from inception to February 2019. Primary outcome measures were DAS28 and SF-36. Eligibility screening and data extraction were completed by two reviewers. Disagreements were resolved by discussion or a third reviewer. Quality assessment was carried out using the Newcastle-Ottawa Scale. RESULTS From 7712 unique citations, 60 articles were assessed for eligibility. The final review included 20 studies involving 7452 people with RA (14 cross-sectional, 6 cohort). Eleven examined disease activity, 6 reported QoL outcome measures and 3 included both. Anxiety was associated with increased disease activity and worse QoL. Meta-analysis showed anxiety to be correlated with increased DAS28 scores (r = 0.23, CI 0.14, 0.31) and reduced physical (r = - 0.39, CI - 0.57, - 0.20) and mental QoL (- 0.50, CI - 0.57, - 0.43). CONCLUSIONS Anxiety in people with RA is associated with increased disease activity and worse QoL. Improved recognition and management of comorbid anxiety may help to improve outcomes for people with RA.Key Points• This is the first systematic review and meta-analysis to examine the relationship between anxiety and disease activity and QoL in people with RA.• Anxiety was associated with higher disease activity both cross-sectionally and at up to 12-month follow-up.• Anxiety may have a more significant impact on disease activity in early RA, highlighting the importance of early recognition and management of comorbid anxiety.• People with anxiety had poorer self-reported physical and mental QoL, although there was some heterogeneity in study findings, particularly for physical QoL (I2 = 78.5%).
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Affiliation(s)
- Annabelle R Machin
- Primary Care Centre Versus Arthritis, School for Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK.
| | - Opeyemi Babatunde
- Primary Care Centre Versus Arthritis, School for Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - Randula Haththotuwa
- Primary Care Centre Versus Arthritis, School for Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - Ian Scott
- Primary Care Centre Versus Arthritis, School for Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK.,Haywood Academic Rheumatology Centre, Midlands Partnership Foundation Trust, Staffordshire, UK
| | - Milica Blagojevic-Bucknall
- Primary Care Centre Versus Arthritis, School for Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - Nadia Corp
- Primary Care Centre Versus Arthritis, School for Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - Carolyn A Chew-Graham
- Primary Care Centre Versus Arthritis, School for Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK.,West Midlands CLAHRC, West Midlands, UK.,Midlands Partnership Foundation Trust, Staffordshire, UK
| | - Samantha L Hider
- Primary Care Centre Versus Arthritis, School for Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK.,Haywood Academic Rheumatology Centre, Midlands Partnership Foundation Trust, Staffordshire, UK.,Midlands Partnership Foundation Trust, Staffordshire, UK
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Oguro N, Yajima N, Miwa Y. Age and quality of life in patients with rheumatoid arthritis treated with biologic agents. Mod Rheumatol 2019; 30:44-49. [DOI: 10.1080/14397595.2018.1551274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Nao Oguro
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Nobuyuki Yajima
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yusuke Miwa
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
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Miwa Y, Isojima S, Saito M, Ikari Y, Kobuna M, Hayashi T, Takahashi R, Kasama T, Hosaka M, Sanada K. Comparative Study of Infliximab Therapy and Methotrexate Monotherapy to Improve the Clinical Effect in Rheumatoid Arthritis Patients. Intern Med 2016; 55:2581-5. [PMID: 27629950 DOI: 10.2169/internalmedicine.55.6872] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective We examined whether infliximab (IFX) therapy was more effective than methotrexate (MTX) monotherapy to achieve an improvement in depressive states in Rheumatoid Arthritis (RA) patients. Methods We examined 152 RA patients (72 IFX patients and 80 MTX patients). We conducted an open-label cohort study to evaluate the disease activity of RA (Simplified Disease Activity Index; SDAI), depressive states (Hamilton Rating Scale for Depression; HAM-D), Activity of Daily Living (ADL) (modified Health Assessment Questionnaire; mHAQ) and Quality of Life (QOL) [Short Form (SF)-36] in patients before and 6 months after receiving therapy. The HAM-D, SDAI, mHAQ and SF-36 scores after 6 months of therapy were measured as the outcomes. Results We analyzed 60 IFX patients and 53 MTX patients. The HAM-D scores significantly improved in both groups (p<0.001), but there was no significant difference in the effectiveness between the IFX and MTX therapies (p=0.792). The SDAI scores significantly improved in both groups after therapy (p<0.001), and IFX therapy was more effective than MTX therapy (p=0.004). The mHAQ and HAM-D scores also improved significantly in both groups after therapy (p<0.001), but no significant difference in the effectiveness between the IFX and MTX therapies was observed (p=0.272, 0.792). The scores of all 8 items of the SF-36 improved in both groups after therapy, but IFX therapy was more effective than MTX therapy in only 4 of the 8 items (p<0.05). Conclusion Both IFX and MTX therapy improved the clinical efficacy, ADL, QOL and depressive states. However, no significant differences regarding an improvement in the depressive states and ADL were observed between IFX therapy and MTX monotherapy.
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Affiliation(s)
- Yusuke Miwa
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Japan
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Tokunaga T, Miwa Y, Nishimi A, Nishimi S, Saito M, Oguro N, Miura Y, Ishii S, Takahashi R, Kasama T, Sanada K. Sex Differences in the Effects of a Biological Drug for Rheumatoid Arthritis on Depressive State. Open Rheumatol J 2015; 9:51-6. [PMID: 26312106 PMCID: PMC4541463 DOI: 10.2174/1874312901409010051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 05/11/2015] [Accepted: 05/18/2015] [Indexed: 11/22/2022] Open
Abstract
Objective : Sex-specific medicine has attracted attention in recent years, but no report on rheumatoid arthritis (RA) has examined sex differences in the effectiveness of biologics on activities of daily living (ADL), quality of life (QOL), or depressive state. Methods : The study subjects were 161 RA patients (female: 138; male: 23) attending regular doctor visits at our hospital. We compared the changes in disease activity, which was evaluated using the simplified disease activity index (SDAI), ADL (using the modified health assessment questionnaire; mHAQ), QOL (using short form-36; SF-36), and the Hamilton Depression Rating Scale (HAM-D) for RA patients between each sex over a six-month observation period while administering biologic treatment. Results : The female patients reported significant improvements in the following metrics: SDAI: from 22.1 ± 11.9 to 8.9 ± 7.8 (p < 0.001); mHAQ: from 0.46 ± 0.50 to 0.32 ± 0.45 (p < 0.001); and HAM-D: from 6.2 ± 4.8 to 3.8 ± 4.1 (p < 0.001). Moreover, all eight items of the SF-36 were significantly improved (p < 0.01). In contrast, the male patients improved on the SDAI (from 27.9 ± 11.7 to 12.7 ± 8.6 (p < 0.001)), but we did not observe significant improvements in the mHAQ or HAM-D scores or in any items on the SF-36. Conclusion : Both male and female patients with RA improved when using a biological drug. Sex differences in the improvement of depressive state were observed.
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Affiliation(s)
- Takahiro Tokunaga
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Yusuke Miwa
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Airi Nishimi
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Shinichiro Nishimi
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Mayu Saito
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Nao Oguro
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Yoko Miura
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Sho Ishii
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Ryo Takahashi
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Tsuyoshi Kasama
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Kenji Sanada
- Department of Psychiatry, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
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Miwa Y, Nishimi A, Nishimi S, Saito M, Tokunaga T, Yanai R, Takahashi R, Wakabayashi K, Kasama T, Hosaka M. Combined infliximab and methotrexate treatment improves the depressive state in rheumatoid arthritis patients more effectively than methotrexate alone. Eur J Rheumatol 2014; 1:147-149. [PMID: 27708901 PMCID: PMC5042244 DOI: 10.5152/eurjrheumatol.2014.140074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 09/03/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Rheumatoid arthritis (RA) patients have a greater depressive tendency than normal subjects, and infliximab is known to provide quick therapeutic effects and to have high bioavailability for RA. We therefore investigated whether the depressive state of RA patients would be improved by infliximab. MATERIAL AND METHODS The Self-Rating Depression Scale (SDS) was used to evaluate 34 RA patients before and 14 or 30 weeks after inflixi mab treatment using the SDS and Disease Activity Score (DAS) 28. The SDS and DAS28 results before and after treatment were compared. RESULTS We also included 42 cases treated with methotrexate as the control group. The SDS decreased in both groups, and the intraindividual vari ability was p<0.001, indicating that the drugs had significantly different effects on the SDS. The DAS tended to decrease in both groups, but the intraindividual variability was p=0.199, indicating no difference between the two drugs. CONCLUSION This study is a preliminary study, but the data suggest that infliximab may reduce RA disease activity and improve the depressive state.
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Affiliation(s)
- Yusuke Miwa
- Department of Rheumatology, Showa University Faculty of Medicine, Tokyo, Japan
| | - Airi Nishimi
- Department of Rheumatology, Showa University Faculty of Medicine, Tokyo, Japan
| | - Shinichiro Nishimi
- Department of Rheumatology, Showa University Faculty of Medicine, Tokyo, Japan
| | - Mayu Saito
- Department of Rheumatology, Showa University Faculty of Medicine, Tokyo, Japan
| | - Takahiro Tokunaga
- Department of Rheumatology, Showa University Faculty of Medicine, Tokyo, Japan
| | - Ryo Yanai
- Department of Rheumatology, Showa University Faculty of Medicine, Tokyo, Japan
| | - Ryo Takahashi
- Department of Rheumatology, Showa University Faculty of Medicine, Tokyo, Japan
| | | | - Tsuyoshi Kasama
- Department of Rheumatology, Showa University Faculty of Medicine, Tokyo, Japan
| | - Michio Hosaka
- Department of Rheumatology, Clini of Katsuyama, Yamanashi, Japan
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Miwa Y, Hosaka M, Ohtsuka K, Sato M, Takahashi R, Wakabayashi K, Odai T, Yajima N, Kasama T. Depression is improved when low-dose tacrolimus is given to rheumatoid arthritis patients showing an inadequate response to biologic agents. Mod Rheumatol 2014. [DOI: 10.3109/s10165-012-0765-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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