Quality of life profiles in the first years of rheumatoid arthritis: Results from the EURIDISS longitudinal study

Objective. The aim of this study was to examine the quality of life (QoL) p rofiles of patients with early rheumatoid arthritis (RA) and to relate thes e to disease and impairment variables as indicated, respectively, by erythr ocyte sedimentation rate (ESR) and by tender joint count (Ritchie Articular Index), fatigue, and pain. Methods. The present study uses part of the European Research on Incapacita ting Disease and Social Support data of 573 patients with recently diagnose d RA (268 from the Netherlands, 216 from Norway, and 89 from France). A ser ies of clinical and psychosocial data were collected on 4 (the Netherlands, France) and 3 (Norway) occasions, with 1-year intervals separating the wav es of data collection. Results. Of the disease activity (ESR) and impairment variables (tender joi nt count, fatigue, pain), fatigue was identified as the consequence of dise ase that differentiated best on a series of QoL aspects such as disability, psychological well-being, social support, and "overall evaluation of healt h." Next came pain and tender joint count, and ESR showed by far the least differentiating ability. A principal-component analysis on the QoL measures used in this study yield ed one general factor measuring "overall QoL." After rotation, two separate factors were encountered, one referring to the physical domain and the oth er to the psychological and social domains of QoL. Again, the QoL of RA pat ients experiencing much fatigue appeared to decline the most. Conclusions. Because of the highly variable nature of RA, impairments, acti vities of daily living (ADL) and instrumental ADL restrictions, and psychos ocial distress can vary erratically. In particular, "fatigue" as measured o ver a period of 2 to 3 years distinguished best among RA patients as shown by their QoL profiles. Although the physical domain was most affected, the significant effect of RA on the psychosocial. domain should not be underest imated.