scholarly journals Complex correction of comorbid nonpsychotic mental disorders in patients with rheumatoid arthritis

2019 ◽  
Vol 27 (2 (99)) ◽  
pp. 56-58
Author(s):  
Svitlana Savka
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Mental Disorders ◽  
Key Words ◽  
Standard Treatment ◽  
Gestalt Therapy ◽  
Psychotherapeutic Treatment ◽  
Psychopharmacological Treatment ◽  
Complex Program

The program for the treatment of nonpsychotic mental disorders (NMD) in patients with rheumatoid arthritis (RA) are described in the article. The complex program of treatment for NMD with the use of psychopharmacotherapy and psychotherapeutic approaches (rational psychotherapy, autogenous training, cognitive-behavioral and gestalt therapy) was developed taking into account the revealed specifi city of clinical-psychopathological manifestations, psychopathological features of comorbid non-psychotic mental disorders in patients with RA. The fi rst group included 51 patients, who, in addition to standard treatment, received only psychopharmacological treatment of NPR (ВGТ I), and the second group — 69 patients receiving complex psychopharmacological and psycho therapeutic treatment (ВGТ II). As evidence shows, the level of depression significantly decreased in the ВGТ II at 11.7 points compared with ВGТ I at 8.1 points. The level of anxiety decreased in ВGТ II at 13.1 points, and in ВGТ I at 8.4 points. The overall assessment of quality of life in ВGТ I, improved by 10.2 points, while ВGТ II — by 15.9 points and the positive eff ect was probable. Key words: nonpsychotic mental disorders, rheumatoid arthritis, psychopharmacological and psychotherapeutic treatment

scholarly journals IMPROVED QUALITY OF LIFE OF PATIENTS WITH RHEUMATOID ARTHRITIS AND NONPSYCHOTIC MENTAL DISORDERS

2019 ◽  
Vol 72 (1) ◽  
pp. 47-51 ◽  
Author(s):  
Svitlana Savka
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Mental Disorders ◽  
Rating Scale ◽  
Life Quality ◽  
Well Being ◽  
Control Group ◽  
Clinical Group ◽  
Hamilton Rating Scale

Introduction: Somatic pathology of patients with rheumatoid arthritis (RA) combined with nonpsychotic mental disorders (NMD) leads to deterioration in the quality of life. The aim: We aimed to examine the quality of life of patients with rheumatoid arthritis and nonpsychotic mental disorders. Materials and methods: We formed two clinical groups of observation of the patients with rheumatoid arthritis and nonpsychotic mental disorders. First group (GA) included participants with duration of RA for 1-5 years, second group (GB) included those with duration of RA for 5-10 years. For assessment we used the Hamilton Rating Scale for Depression (HRSD), Hamilton Rating Scale for Anxiety (HRSA) and the Quality of Life Index developed by J.E. Mezzich (QLI). All patients received basic treatment, as well as antidepressants, anxiolytics, vitamin therapy and psychotherapy, depending on the form of nonpsychotic mental disorders. Results: Study of the life quality showed that for the examined patients the quality of life was significantly lower in comparison with the control group. Mainly, for GA partners the overall assessment of life quality after treatment improved by 12,1% and the positive effect was probable. The greatest positive changes for the first group included increasing of physical well-being points by 2,5 and psychological/emotional well-being – by 2,1 points(p<0,05). Mainly, for GB patients overall quality of life improved by 14,9%. Major positive changes were identified in psychological/emotional well-being - 2,93 points, physical well-being by 2,47 points, self-care and independent functioning by 2,09 points, and disability which increased by 2,06 points (p <0,05) Conclusions: The patients with rheumatoid arthritis and nonpsychotic mental disorders have a significant decline in quality of life based on all indicators. The general assessment of the life quality of the first basic clinical group surveyed was 62,2 ± 1,33, while for the second basic clinical group surveyed – 57,0 ± 1,47. The increase in the duration of the RA disease significantly weakens the general working capacity by 0,83 points p<0,05, self-service and independence of the patients by 0,80 points, p<0,05, psychological and emotional well-being by 0,75 points, p<0,05, interpersonal interaction at 0,91 points, p<0,05.The overall quality of life of the patients with duration of RA for 1-5 years and NMD after treatment was 74,1% ± 0,93, for the patients with duration of RA for 5-10 years and NMD after treatment was 71,9% ± 1,20 (p <0,05).

Psychosomatic Features, Compliance and Complementary Therapies in Rheumatoid Arthritis

2020 ◽  
Vol 16 (3) ◽  
pp. 215-223
Author(s):  
Rostislav A. Grekhov ◽  
Galina P. Suleimanova ◽  
Andrei S. Trofimenko ◽  
Liudmila N. Shilova
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Interpersonal Relationships ◽  
Behavioral Therapy ◽  
Current Data ◽  
Psychotherapeutic Interventions ◽  
And Coping ◽  
Regulation Of Emotion ◽  
The Impact

This review highlights the issue of psychosomatic conditions in rheumatoid arthritis, paying special attention to new researches and trends in this field. Emerging concepts in all the major parts of the problem are covered consecutively, from the impact of chronic musculoskeletal pain on the emotional state to disease influence over quality of life, socio-psychological, and interpersonal relationships. Chronic pain is closely related to emotional responses and coping ability, with a pronounced positive effect of psychotherapeutic interventions, family and social support on it. Psychosexual disorders, anxiety, depression also commonly coexist with rheumatoid arthritis, leading to further decrease in quality of life, low compliance, and high suicide risk. Influence of psychosomatic conditions on the overall treatment effect is usually underestimated by rheumatologists and general practitioners. Psychosomatic considerations are of great importance for up-to-date management of rheumatoid arthritis, as they strongly influence the quality of life, compliance, and thereby disease outcomes. Two major approaches of psychological rehabilitation exist, both coping with pain through the regulation of emotion and psychotherapeutic intervention, which not only helps patients in coping with the disease, but also aimed at improving the overall adaptation of the patient. It includes techniques of relaxation, cognitive-behavioral therapy, and biofeedback therapy. Current data about the efficacy of the additional correcting therapies for patients with rheumatoid arthritis, both emerging and common ones, are discussed in the review.

Evaluating the efficacy of intra-articular injections of platelet rich plasma (PRP) in rheumatoid arthritis patients and its impact on inflammatory cytokines, disease activity and quality of life.

2020 ◽  
Vol 16 ◽  
Author(s):  
Dalia S. Saif ◽  
Nagwa N. Hegazy ◽  
Enas S. Zahran
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Inflammatory Cytokines ◽  
Platelet Rich Plasma ◽  
Joint Inflammation ◽  
Monthly Interval ◽  
Post Injection ◽  
Tnf Α

Background: Among rheumatoid arthritis patients (RA), general disease activity is well regulated by diseasemodifying anti-rheumatic medications (DMARDS), but sometimes local inflammation still persists among a few joints. Adjuvant modern molecular interventions as Platelet Rich Plasma (PRP) with a suggested down regulating effect on inflammatory mediators has a proven effect in management of RA. We aim to evaluate the therapeutic effect of intra-articular PRP versus steroid in RA patients and their impact on inflammatory cytokines IL1B , TNF α, local joint inflammation, disease activity and quality of life (QL). Methods: Open labeled parallel randomized control clinical trial was carried out on 60 RA patients randomly divided into 2 groups, Group 1: included 30 patients received 3 intra-articular injections of PRP at monthly interval, Group 2: included 30 patients received single intra-articular injection of steroid. They were subjected to clinical, laboratory, serum IL1B and TNF α assessment at baseline and at 3, 6 months post injection. Results: Patients of both groups showed improvements in their scores of evaluating tools at 3months post injection and this improvement was persistent in the PRP group up to 6 months post injection while it was continued only for 3 months in the steroid group. Conclusions: PRP is a safe, effective and useful therapy in treating RA patients who had insufficient response and persistent pain and inflammation in just one or two joints through its down regulating effect on inflammatory cytokines IL1B, TNF α with subsequent improvement of local joint inflammation, disease activity and QL.

scholarly journals The effects of intensive home treatment on self-efficacy in patients recovering from a psychiatric crisis

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Ansam Barakat ◽  
Matthijs Blankers ◽  
Jurgen E Cornelis ◽  
Nick M Lommerse ◽  
Aartjan T F Beekman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Disorders ◽  
Self Efficacy ◽  
Psychotic Disorders ◽  
Rating Scale ◽  
Small Sample ◽  
Home Treatment ◽  
Differential Effects ◽  
Psychiatric Crisis

Abstract Background This study evaluated whether providing intensive home treatment (IHT) to patients experiencing a psychiatric crisis has more effect on self-efficacy when compared to care as usual (CAU). Self-efficacy is a psychological concept closely related to one of the aims of IHT. Additionally, differential effects on self-efficacy among patients with different mental disorders and associations between self-efficacy and symptomatic recovery or quality of life were examined. Methods Data stem from a Zelen double consent randomised controlled trial (RCT), which assesses the effects of IHT compared to CAU on patients who experienced a psychiatric crisis. Data were collected at baseline, 6 and 26 weeks follow-up. Self-efficacy was measured using the Mental Health Confidence Scale. The 5-dimensional EuroQol instrument and the Brief Psychiatric Rating Scale (BPRS) were used to measure quality of life and symptomatic recovery, respectively. We used linear mixed modelling to estimate the associations with self-efficacy. Results Data of 142 participants were used. Overall, no difference between IHT and CAU was found with respect to self-efficacy (B = − 0.08, SE = 0.15, p = 0.57), and self-efficacy did not change over the period of 26 weeks (B = − 0.01, SE = 0.12, t (103.95) = − 0.06, p = 0.95). However, differential effects on self-efficacy over time were found for patients with different mental disorders (F(8, 219.33) = 3.75, p < 0.001). Additionally, self-efficacy was strongly associated with symptomatic recovery (total BPRS B = − 0.10, SE = 0.02, p < 0.00) and quality of life (B = 0.14, SE = 0.01, p < 0.001). Conclusions Although self-efficacy was associated with symptomatic recovery and quality of life, IHT does not have a supplementary effect on self-efficacy when compared to CAU. This result raises the question whether, and how, crisis care could be adapted to enhance self-efficacy, keeping in mind the development of self-efficacy in depressive, bipolar, personality, and schizophrenia spectrum and other psychotic disorders. The findings should be considered with some caution. This study lacked sufficient power to test small changes in self-efficacy and some mental disorders had a small sample size. Trial registration This trial is registered at Trialregister.nl, number NL6020.

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