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Screening for Anxiety in Patients With Inflammatory Arthritis Using the Multidimensional Health Assessment

Sadia Tasnim Islam1, Joseph Descallar2, David Martens3

  • 1S.T. Islam, MD, Department of Rheumatology, Liverpool Hospital, Liverpool; sadia91.ti@gmail.com.

The Journal of Rheumatology
|July 3, 2023
PubMed
Summary
This summary is machine-generated.

The Multidimensional Health Assessment Questionnaire (MDHAQ) effectively screens for anxiety in rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients. This tool offers a valuable alternative to the Hospital Anxiety and Depression Scale (HADS) in routine clinical practice.

Keywords:
anxietypatient-reported outcome measurespsoriatic arthritisrheumatoid arthritis

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Area of Science:

  • Rheumatology
  • Psychiatry
  • Clinical Assessment

Background:

  • Anxiety is a common comorbidity in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA).
  • Screening for anxiety is crucial for comprehensive patient management in rheumatology settings.
  • The Multidimensional Health Assessment Questionnaire (MDHAQ) is a comprehensive tool used in rheumatology practice.

Purpose of the Study:

  • To evaluate the efficacy of the Multidimensional Health Assessment Questionnaire (MDHAQ) in screening for anxiety among patients diagnosed with RA and PsA.
  • To compare the performance of the MDHAQ against the Hospital Anxiety and Depression Scale (HADS), a validated reference standard for anxiety screening.

Main Methods:

  • A cohort of 183 patients with RA or PsA completed both the MDHAQ and HADS during routine clinic visits.
  • The study assessed two specific items on the MDHAQ for anxiety screening.
  • Statistical analyses, including sensitivity, specificity, and agreement (kappa statistic), were performed to compare MDHAQ performance against HADS-Anxiety (HADS-A) scores of 8 or higher.

Main Results:

  • The study included 183 participants (68.9% RA, 31.1% PsA), with 39.3% screening positive for anxiety based on HADS-A.
  • The MDHAQ demonstrated a sensitivity of 69.9% and specificity of 73.6% in identifying patients with anxiety compared to HADS-A.
  • Substantial agreement (80.9% agreement, kappa = 0.59) was observed between the MDHAQ and HADS for anxiety screening.

Conclusions:

  • The MDHAQ shows comparable performance to the HADS in screening for anxiety in RA and PsA patients.
  • Utilizing the MDHAQ for anxiety screening can streamline clinical practice by integrating this assessment with routine monitoring of clinical status and screening for other conditions like fibromyalgia and depression.
  • The MDHAQ presents a practical and efficient tool for enhancing anxiety detection in rheumatology care.