- 作者：James Andrew Prior ; j.a.prior@keele.ac.uk" class="auth_mail" title="E-mail the corresponding author ; Christian D. Mallen ; Priyanka Chandratre ; Sara Muller ; Jane Richardson ; Edward Roddy
- 关键词：Allopurinol ; Anxiety ; Comorbidity ; Depression ; Gout ; Primary care
- 刊名：Joint Bone Spine
- 出版年：2016
- 出版时间：October 2016
- 年：2016
- 卷：83
- 期：5
- 页码：553-558
- 全文大小：504 K
Method
As part of a prospective cohort study, a baseline questionnaire was sent to 1805 participants with gout aged ≥ 18 years from UK primary care. Participants had a gout diagnosis or prescriptions for allopurinol or colchicine in their medical records 2 years prior to baseline. Prevalence of anxiety was defined using the Generalised Anxiety Disorder questionnaire and depression using the Patient Health Questionnaire. Logistic regression was used to examine any association between gout characteristics (12-month attack frequency, oligo/polyarticular gout and gout duration) and the presence of anxiety or depression. Crude and adjusted associations were reported as odds ratios (OR) and 95% confidence intervals (CI). Adjusted gout characteristics were stratified by allopurinol use.
Results
One thousand one hundred and eighty-four participants responded to baseline (65.6%). Prevalence of anxiety and depression were 10.0% and 12.6% respectively. There was no association between gout characteristics and anxiety. However, there was an association between attack frequency and depression amongst those gout patients using allopurinol (2.87 [1.2 to 6.6]) and also between oligo/polyarticular gout and depression (2.01 [1.2 to 3.3]), irrespective of allopurinol use (2.09 [1.1 to 4.0]) or not (2.64 [1.0 to 6.8]).
Conclusion
Patients experiencing frequent gout attacks or attacks in multiple joints are likely to experience depressive symptoms, even when using allopurinol. Depression may influence medication adherence and participation in routine reviews, hence impacting adversely on gout management outcomes.