TY  - JOUR
A1  - Froehlich, Matthias
A1  - Zahner, Antonia
A1  - Schmalzing, Marc
A1  - Gernert, Michael
A1  - Strunz, Patrick-Pascal
A1  - Hueper, Sebastian
A1  - Portegys, Jan
A1  - Schwaneck, Eva Christina
A1  - Gadeholt, Ottar
A1  - Kübler, Andrea
A1  - Hewig, Johannes
A1  - Ziebell, Philipp
T1  - Patient-reported outcomes provide evidence for increased depressive symptoms and increased mental impairment in giant cell arteritis
JF  - Frontiers in Medicine
N2  - Objectives 
The spectrum of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) represents highly inflammatory rheumatic diseases. Patients mostly report severe physical impairment. Possible consequences for mental health have been scarcely studied. The aim of this study was to investigate psychological well-being in the context of GCA and PMR.

Methods 
Cross-sectional study with N = 100 patients with GCA and/or PMR (GCA-PMR). Patient-reported outcomes (PROs) were measured using the Short Form 36 Version 2 (SF-36v2) and visual analog scale (VAS) assessment. Moreover, the Patient Health Questionnaire 9 (PHQ-9) was used in 35 of 100 patients to detect depression. To compare PROs with physician assessment, VAS was also rated from physician perspective. To assess a possible association with inflammation itself, serological parameters of inflammation (C-reactive protein [CRP], erythrocyte sedimentation rate [ESR]) were included.

Results 
In all scales of the SF-36v2 except General Health (GH) and in the physical and mental sum score (PCS, MCS), a significant impairment compared to the German reference collective was evident (MCS: d = 0.533, p < 0.001). In the PHQ-9 categorization, 14 of the 35 (40%) showed evidence of major depression disorder. VAS Patient correlated significantly with PHQ-9 and SF-36 in all categories, while VAS Physician showed only correlations to physical categories and not in the mental dimensions. Regarding inflammatory parameters, linear regression showed CRP to be a complementary significant positive predictor of mental health subscale score, independent of pain.

Conclusion 
PRO show a relevant impairment of mental health up to symptoms of major depression disorder. The degree of depressive symptoms is also distinctly associated with the serological inflammatory marker CRP.
KW  - giant cell arteritis
KW  - PRO
KW  - depression
KW  - mental impairment
KW  - SF-36
KW  - PHQ-9
KW  - VAS
KW  - polymyalgia rheumatica
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-319761
VL  - 10
ER  -