title: Psychological state is related to the remission of the Boolean-based definition of patient global assessment in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To evaluate whether the psychological state is related to the Boolean-based definition of patient global assessment (PGA) remission in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  Patients with RA who met the criteria of swollen joint count (SJC) ≤ 1, tender joint count (TJC) ≤ 1 and C-reactive protein (CRP) ≤ 1 were divided into two groups, PGA remission group (PGA ≤ 1 cm) and non-remission group (PGA > 1 cm). Anxiety was evaluated utilizing the Hospital Anxiety and Depression Scale-Anxiety (HADS-A), while depression was evaluated with HADS-Depression (HADS-D) and the Center for Epidemiologic Studies Depression Scale (CES-D). Comparison analyses were done between the PGA remission and non-remission groups in HADS-A, HADS-D and CES-D.
  
  
  RESULTS
  Seventy-eight patients met the criteria for SJC ≤ 1, TJC ≤ 1 and CRP ≤ 1. There were no significant differences between the PGA remission group (n = 45) and the non-remission group (n = 33) in age, sex, disease duration and Steinbrocker's class and stage. HADS-A, HADS-D and CES-D scores were significantly lower in the PGA remission group.
  
  
  CONCLUSIONS
  Patients with RA who did not meet the PGA remission criteria despite good disease condition were in a poorer psychological state than those who satisfied the Boolean-based definition of clinical remission. Psychological support might be effective for improvement of PGA, resulting in the attainment of true remission.
authors: a Division of Nursing, NTT West Osaka Hospital , Osaka , Japan.
authors: Mie
authors: M
authors: Fusama
authors: Yasushi
authors: Y
authors: Miura
authors: Kumiko
authors: K
authors: Yukioka
authors: Takanori
authors: T
authors: Kuroiwa
authors: Chikako
authors: C
authors: Yukioka
authors: Miyako
authors: M
authors: Inoue
authors: Tae
authors: T
authors: Nakanishi
authors: Norikazu
authors: N
authors: Murata
authors: Noriko
authors: N
authors: Takai
authors: Kayoko
authors: K
authors: Higashi
authors: Taro
authors: T
authors: Kuritani
authors: Keiji
authors: K
authors: Maeda
authors: Hajime
authors: H
authors: Sano
authors: Masao
authors: M
authors: Yukioka
authors: Hideko
authors: H
authors: Nakahara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000523:psychology*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000523:psychology*; D002097:C-Reactive Protein / Q000378:metabolism; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D002097:C-Reactive Protein
keywords: Anxiety; Depression; Patient global assessment; Psychological remission; Rheumatoid arthritis