ANXIETY MASKS THE EFFECT OF PAIN AND DISEASE ACTIVITY ON SEXUAL FUNCTION

Background: There are growing evidences that increasing the pain level disturbs the sexual function. Also by increasing the disease activity of the rheumatoid arthritis the sexual function decreases significantly. Some studies have shown that mental morbidities like anxiety may mask the other problems.The aim of the current study is to investigate if anxiety interferes with the correlation of pain and disease activity with sexual function, in a group of rheumatoid patients.Methods: This was a cross sectional study. Participants were 395 patients with definite diagnosis of rheumatoid arthritis (RA) from outpatient rheumatologic clinic of Baqiyatallah Hospital, Iran. The study was held between June to December 2006. We measured the demographic data, disease duration, patients' global assessment (using a 100mm horizontal visual analogue scale (VAS)), pain during the past month (100mm horizontal VAS), disease severity (28 items disease activity score (DAS-28)), patients' anxiety (hospital anxiety and depression scale (HADS)) and the sexual function of the patients (relationship and sexuality scale).Considering the cut point of 11 for the score of anxiety, patients who scored more than 11 considered as having "anxiety". The correlation between scores of sexual function with pain, fatigue and disease activity was evaluated using Pearson correlation coefficient. The P-value of more than 0.05 considered as statistically significant. Data analysis was performed using the SPSS 13 for windows software.Results: The mean age of the patients was 46.7±12.1 years with 347 (87.4%) of them being female. The mean disease duration was 79.1±72.4 months.Of these patient, 141(35.7%) had a score of more than 11 and considered as having anxiety. The two groups were matched on age and sex. The mean scores of pain and disease activity were not significantly different between the two groups of the patients. The score of the sexual function was 9.2±2.7 in the group of the patients with no anxiety and 9.7±3.0 in those with anxiety (p= NS).In the group of patients with no anxiety, the score of sexual function was significantly correlated with pain (r= 295, p<0.001 and the score of the DAS-28 (r=0.281, p =0.02). This relationship was not observed in the patients with anxiety (pain: r= 0.123, r= 0.361; DAS-28: r=0.284, p=0.11).Conclusion: We observed that despite having the same level of pain, disease activity and sexual function in the two groups, the disease and pain severity showed no correlation with the sexual function in patients with no anxiety. It seems that the higher levels of anxiety mask such correlations.Citation: Ann Rheum Dis, volume 66, supplement II, year 2007, page 367Session: RA – other clinical aspects and comorbidity