Elevated DAS28, CDAI, RAPID3, and 5/7 RA core data set measures in patients with positive screens for anxiety, depression or fibromyalgia on an MDHAQ.

Objective: To analyze positive 3 patient distress MDHAQ (multidimensional health assessment questionnaire) screening indices, MAS2 (MDHAQ anxiety screen), MDS2 (MDHAQ depression screen), and FAST3F (fibromyalgia assessment screening tool), for possible elevations of rheumatoid arthritis (RA) activity/severity indices in routine care patients.

Methods: A cross-sectional database included the 7 RA core data set measures and 3 MDHAQ patient distress indices. Mean individual measures and 5 indices, DAS28-ESR (disease activity score 28-erythrocyte sedimentation rate), DAS28-CRP (DAS28-C-reactive protein), simplified disease activity index (SDAI), clinical disease activity index (CDAI), and RAPID3 (routine assessment of patient index data), and the number of patients classified as high, moderate, low, or remission were computed according to positive or negative MDHAQ screening indices, including in patients with 0,1 versus ≥2 swollen joints, analyzed using t tests and chi-square tests.

Results: Among 173 patients, positive screening was seen in 37% for MAS2, 27% for MDS2, 31% for FAST3F, and 45% for any of these MDHAQ screening indices. All 5 RA indices and 5/7 core data set measures were elevated significantly (p < 0.01), other than swollen joint count (SJC), ESR, and CRP, in MAS2, MDS2 and/or FAST3F, positive patients, generally to a higher activity/severity category. In the 27%-41% of all patients with 0,1 SJC but moderate/high RA index activity/severity, a positive MDHAQ anxiety, depression, and/or fibromyalgia screen was seen in 54%-100%.

Conclusions: RA indices and 5/7 core data set measures are elevated significantly in patients who screened positive vs negative on MDHAQ indices for anxiety, depression, and/or fibromyalgia.