From pain catastrophising to multidimensional psychological distress: unravelling the complexity of difficult-to-treat psoriatic arthritis.

IF 3.4 4区医学 Q2 RHEUMATOLOGY

Clinical and experimental rheumatology Pub Date : 2025-05-31 DOI:10.55563/clinexprheumatol/2pmt67

Damiano Currado, Francesca Saracino, Francesco De Vincenzo, Francesca Trunfio, Annalisa Marino, Lyubomyra Kun, Erika Corberi, Ludovica Lamberti, Leonardo Frascà, Onorina Berardicurti, Marta Gatti, Marta Vomero, Roberto Giacomelli, Luca Navarini

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引用次数: 0

Abstract

Objectives: Pain catastrophising (PC), a maladaptive cognitive response to pain, has been implicated in poor outcomes in inflammatory arthritis, but its relationship with psoriatic arthritis difficult-to-treat (D2T) remains underexplored. This study aimed to investigate how the D2T phenotype impacts pain catastrophising (PC) and its domains (helplessness, rumination, magnification), along with other psychosocial and functional dimensions in PsA patients.

Methods: A cross-sectional study was conducted in a cohort of 182 PsA patients. Clinical and psychosocial data were collected, including Disease Activity for Psoriatic Arthritis (DAPSA), Minimal Disease Activity (MDA), Pain Catastrophising Scale (PCS), HADS anxiety and HADS depression. Univariable and multivariable regressions were used to evaluate psychometric variables associated with D2T.

Results: Univariable analysis showed a significant association between high PCS scores and D2T status. Multivariable models, adjusted for age, sex, disease duration, BMI, fibromyalgia, and disease activity, confirmed this relationship (b=7.637, 95% CI 3.261-12.014, p=0.001), specifically with PCS' dimensions helplessness and rumination, but not magnification. Additionally, D2T predicted higher HADS anxiety scores, while its association with HADS depression was not statistically significant.

Conclusions: Our results indicate that D2T status remains a significant predictor of PC, even when controlling for relevant clinical characteristics, including fibromyalgia and disease activity, highlighting the intricate relationship between D2T PsA and psychological dimensions, which may exacerbate disease burden and hinder treatment targets.

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从疼痛灾难到多维心理困扰：揭开难治性银屑病关节炎的复杂性。

目的：疼痛灾变（PC）是一种对疼痛的不适应认知反应，与炎症性关节炎的不良预后有关，但其与银屑病关节炎难治性（D2T）的关系仍未得到充分探讨。本研究旨在探讨D2T表型如何影响PsA患者的疼痛灾难（PC）及其领域（无助、反刍、放大）以及其他社会心理和功能维度。方法：对182例PsA患者进行横断面研究。收集临床和社会心理数据，包括银屑病关节炎的疾病活动性（DAPSA）、最小疾病活动性（MDA）、疼痛灾难量表（PCS）、HADS焦虑和HADS抑郁。使用单变量和多变量回归来评估与D2T相关的心理测量变量。结果：单变量分析显示，高PCS评分与D2T状态之间存在显著相关性。调整了年龄、性别、病程、BMI、纤维肌痛和疾病活动度的多变量模型证实了这种关系（b=7.637, 95% CI 3.261-12.014, p=0.001），特别是PCS的维度无助和反刍，但没有放大。此外，D2T预测较高的HADS焦虑评分，而其与HADS抑郁的相关性无统计学意义。结论：我们的研究结果表明，即使在控制相关临床特征（包括纤维肌痛和疾病活动性）的情况下，D2T状态仍然是PC的重要预测因子，这突出了D2T PsA与心理维度之间的复杂关系，这可能会加重疾病负担并阻碍治疗目标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and experimental rheumatology 医学-风湿病学

CiteScore

6.10

自引率

18.90%

发文量

377

审稿时长

3-6 weeks

期刊介绍： Clinical and Experimental Rheumatology is a bi-monthly international peer-reviewed journal which has been covering all clinical, experimental and translational aspects of musculoskeletal, arthritic and connective tissue diseases since 1983.