title: Disability and health-related quality of life among patients with rheumatoid arthritis: association with radiographic joint damage, disease activity, pain, and depressive symptoms.
abstract: OBJECTIVE
  To study the associations between disability and health-related quality of life (HRQoL), respectively, and radiographic joint damage, disease activity, pain, and depressive symptoms among patients with rheumatoid arthritis (RA).
  
  
  METHODS
  Data were collected through questionnaires and clinical examinations at baseline (1997) and at 2 years' follow-up among patients with RA (n = 307). Disability was measured with a validated Dutch questionnaire, derived from the Health Assessment Questionnaire (HAQ), and HRQoL with a validated Dutch version of the RAND-36, using physical (PCS) and mental (MCS) component summary scales. Multivariate linear regression analyses were performed to assess the relationship between disability or HRQoL and radiographic damage, disease activity, pain, and depressive symptoms.
  
  
  RESULTS
  Pain, with respect to disability and PCS, and depressive symptoms, with respect to MCS, were more important predictors than radiographic damage and disease activity.
  
  
  CONCLUSIONS
  Daily RA practice needs to be broadened by regular assessment of disease burden from the patients' perspectives. Patient-reported measures, such as disability or HRQoL, should be incorporated for monitoring health outcomes of individual patients and for initiating and evaluating therapy.
authors.affiliation: Department of Social Medicine, Academic Medical Centre, University of Amsterdam, the Netherlands. i.rupp@amc.uva.nl
authors.forename: I
authors.initials: I
authors.lastname: Rupp
authors.forename: H C
authors.initials: HC
authors.lastname: Boshuizen
authors.forename: H J
authors.initials: HJ
authors.lastname: Dinant
authors.forename: C E
authors.initials: CE
authors.lastname: Jacobi
authors.forename: G A M
authors.initials: GA
authors.lastname: van den Bos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000503:physiopathology; D005260:Female; D033023:Foot Joints / Q000000981:diagnostic imaging / Q000503:physiopathology*; D050823:Hand Joints / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D011788:Quality of Life / Q000523:psychology; D011859:Radiography