Association between patient's psychological health and discordance in patient-physician assessment of psoriatic arthritis

Abstract

Objectives: This study aimed to evaluate the discordance in patient-physician assessment of psoriatic arthritis disease activity and its association with the patient's psychological health.

Methods: This cross-sectional study recruited 135 patients with PsA from Xiangya Hospital of China between October 2021 and July 2022. The visual analogue scale was used to assess the disease activity of PsA, and an absolute difference of ≥ 10 points between the patient-physician global assessment on visual analogue scale was regarded as a clinically relevant discordance. In addition, the patients' clinical data and self-reported questionnaire responses were collected to screen depressive and anxiety symptoms.

Results: Discordance in patient-physician assessment of psoriatic arthritis activity occurred in 88 (65.2%) patients, while concordance occurred in 47 (34.8%) patients. Depressive symptoms (AOR: 4.43, 95% CI:1.85-10.61), as well as anxiety symptoms (AOR: 3.95, 95% CI:1.70-9.16), were associated with the discordance in disease activity assessment between the patients and physicians.

Conclusion: This study suggests that the discordance in patient-physician assessment of psoriatic arthritis activity is associated with the patient's psychological health. Therefore, sufficient assessment of patient's psychological health is indispensable from a comprehensive understanding of the disease activity in patients with psoriatic arthritis. Key Points • This is the first study to evaluate the discordance in patient-physician assessment of psoriatic arthritis disease activity and its association with the patient's psychological health.

Keywords: Anxiety; Depression; Patient-physician assessment; Psoriatic arthritis; Psychological health.