Prospective study of posttraumatic stress disorder and disease activity outcomes in US veterans with rheumatoid arthritis

Ted R. Mikuls, Prasad R. Padala, Harlan R. Sayles, Fang Yu, Kaleb Michaud, Liron Caplan, Gail S. Kerr, Andreas Reimold, Grant W. Cannon, J. Steuart Richards, Deana Lazaro, Geoffrey M. Thiele, Joseph A. Boscarino

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective To examine the relationship between posttraumatic stress disorder (PTSD) and disease activity in US veterans with rheumatoid arthritis (RA). Methods US veterans with RA were enrolled in a longitudinal observational study and were categorized as having PTSD, other anxiety/depression disorders, or neither of these psychiatric diagnoses using administrative codes. Generalized linear mixed-effects models were used to examine the associations of the diagnostic groups with outcomes measured over a mean followup period of 3.0 years. Results At enrollment, 1,522 patients had a mean age of 63 years, they were primarily men (91%), and a majority (78%) reported white race. A diagnosis of PTSD was observed in 178 patients (11.7%), and other anxiety/depression diagnoses (excluding PTSD) were found in 360 patients (23.7%). The presence of a PTSD diagnosis was independently associated with higher values of self-reported pain, physical impairment, tender joint count, and worse patient global well-being scores compared to patients with no psychiatric diagnosis. There were no significant group differences in swollen joint count, erythrocyte sedimentation rate, or Disease Activity Score in 28 joints. There were no differences between any outcomes comparing those with PTSD and those with other anxiety/depression diagnoses. Conclusion In this RA cohort, the diagnosis of PTSD was associated with worse patient-reported outcomes and tender joint counts, but not with other physician- or laboratory-based measures of disease activity. These results suggest that PTSD, along with other anxiety/depression disorders, may affect RA disease activity assessments that rely on patient-reported outcomes and the resulting treatment decisions.

Original languageEnglish (US)
Pages (from-to)227-234
Number of pages8
JournalArthritis Care and Research
Volume65
Issue number2
DOIs
StatePublished - Feb 2013

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Veterans
Post-Traumatic Stress Disorders
Rheumatoid Arthritis
Prospective Studies
Joints
Depression
Anxiety Disorders
Mental Disorders
Anxiety
Blood Sedimentation
Observational Studies
Longitudinal Studies
Physicians
Pain

ASJC Scopus subject areas

  • Rheumatology

Cite this

Mikuls, T. R., Padala, P. R., Sayles, H. R., Yu, F., Michaud, K., Caplan, L., ... Boscarino, J. A. (2013). Prospective study of posttraumatic stress disorder and disease activity outcomes in US veterans with rheumatoid arthritis. Arthritis Care and Research, 65(2), 227-234. https://doi.org/10.1002/acr.21778

Prospective study of posttraumatic stress disorder and disease activity outcomes in US veterans with rheumatoid arthritis. / Mikuls, Ted R.; Padala, Prasad R.; Sayles, Harlan R.; Yu, Fang; Michaud, Kaleb; Caplan, Liron; Kerr, Gail S.; Reimold, Andreas; Cannon, Grant W.; Richards, J. Steuart; Lazaro, Deana; Thiele, Geoffrey M.; Boscarino, Joseph A.

In: Arthritis Care and Research, Vol. 65, No. 2, 02.2013, p. 227-234.

Research output: Contribution to journalArticle

Mikuls, TR, Padala, PR, Sayles, HR, Yu, F, Michaud, K, Caplan, L, Kerr, GS, Reimold, A, Cannon, GW, Richards, JS, Lazaro, D, Thiele, GM & Boscarino, JA 2013, 'Prospective study of posttraumatic stress disorder and disease activity outcomes in US veterans with rheumatoid arthritis', Arthritis Care and Research, vol. 65, no. 2, pp. 227-234. https://doi.org/10.1002/acr.21778
Mikuls, Ted R. ; Padala, Prasad R. ; Sayles, Harlan R. ; Yu, Fang ; Michaud, Kaleb ; Caplan, Liron ; Kerr, Gail S. ; Reimold, Andreas ; Cannon, Grant W. ; Richards, J. Steuart ; Lazaro, Deana ; Thiele, Geoffrey M. ; Boscarino, Joseph A. / Prospective study of posttraumatic stress disorder and disease activity outcomes in US veterans with rheumatoid arthritis. In: Arthritis Care and Research. 2013 ; Vol. 65, No. 2. pp. 227-234.
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