J Rheum Dis.  2025 Jan;32(1):38-47. 10.4078/jrd.2024.0074.

Impact of disease-related indicators on pain measures in rheumatoid arthritis: a biopsychosocial perspective

• Kim H
• Jung JY
• Kim JW
• Suh CH
• Kim HA

• KMID: 2562658
• DOI: http://doi.org/10.4078/jrd.2024.0074

Abstract

Objective
Pain is a significant and debilitating symptom of rheumatoid arthritis (RA) that significantly affects the quality of life and functional ability of patients. In the present study, we examined the association between pain variables and disease activity markers in patients with RA.
Methods
We enrolled 133 patients with RA and assessed their clinical characteristics, socioeconomic and psychological factors, and pain measures. The psychological factors assessed included depressive symptoms and pain catastrophizing.
Results
The study cohort comprised predominantly female patients with RA with an average age of 55.5±10.1 years. Depressive symptoms had a mean score of 5.83±4.71, while pain catastrophizing had an average score of 14.36±10.70. The mean scores for pain intensity, and pain interference, were 2.98±1.75 and 19.54±16.17, respectively, with significant positive correlations observed with depressive symptoms. Hemoglobin and hematocrit levels were negatively correlated with pain intensity. Multivariable linear regression analysis revealed significant associations between depressive symptoms and pain intensity, catastrophizing, and interference. Other factors associated with pain intensity included tender joint count. Pain catastrophizing was associated with education and economic status. Pain interference was associated with sex and economic status.
Conclusion
This study shows the influence of disease-related indicators and psychological factors on pain in patients with RA, with depressive symptoms playing a crucial role in predicting pain experience. Effective pain management strategies for RA should include the management of depressive symptoms, in addition to addressing disease-related indicators.

Keyword

Rheumatoid arthritis; Pain intensity; Pain interference; Pain catastrophizing; Depression

Figure

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  Figure 1 Correlations between pain variables and disease-related indicators in RA patients. Pain intensity shows positive correlations with pain duration and depressive symptoms. Hb and Hct levels are negatively correlated with pain intensity. The DAS28 and TJC are also positively correlated with pain intensity. Pain catastrophizing and pain interference are also positively correlated with depressive symptoms. RA: rheumatoid arthritis, DAS28: Disease Activity Score 28, PHQ: Patient Health Questionnaire, Hb: hemoglobin, Hct: hematocrit, TJC: tender joint count.

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