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Psychological Distress, Somatic Symptom Burden, and Quality of Life in Rheumatoid Arthritis: A Cross-Sectional Study in Bosnia and Herzegovina

AI Summary
  • Higher psychological and somatic symptom scores showed significant inverse associations with quality of life (MANSA), standardized betas 0.24 to 0.49.
  • PHQ-9, GAD-7, PHQ-15 and GSI correlated with MANSA; strongest correlations were GSI rho 0.53 and PHQ-9 rho 0.49 (negative).
  • PHQ-15 and GSI associated with pain and disability (pain rho 0.36, HAQ-DI rho 0.31); findings are exploratory, not causal.
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Healthcare (Basel). 2026 Sep 25;14(19):3179. doi: 10.3390/healthcare14193179.

ABSTRACT

BACKGROUND: Rheumatoid arthritis (RA) affects physical and psychological well-being, but Southeast European evidence is limited.

METHODS: This cross-sectional study included 85 consecutive adults with RA at a tertiary rehabilitation center. Participants completed Bosnian translations of the PHQ-9, GAD-7, PHQ-15, Brief Symptom Inventory, and MANSA. Same-day assessment included pain VAS, DAS28-CRP(3), and HAQ-DI. Continuous scores were analyzed using 20 Spearman correlations with FDR adjustment and four exploratory MANSA models with HC3-robust standard errors. Four internally discordant GSI records were excluded from primary GSI analyses (n = 81). Post hoc sensitivity analyses included all 85 records.

RESULTS: Mean DAS28-CRP(3), HAQ-DI, and MANSA scores were 5.31, 1.69, and 4.37. MANSA correlated with PHQ-9 (rho = -0.49), GAD-7 (-0.30), PHQ-15 (-0.37), and GSI (-0.53; all q ≤ 0.016). PHQ-15 correlated with pain (rho = 0.36) and HAQ-DI (0.31), PHQ-9 correlated with HAQ-DI (0.25), and GSI correlated with pain and HAQ-DI (both 0.28; all q < 0.05). Adjusted MANSA associations remained (standardized beta = -0.49 to -0.24; all q < 0.05), with conclusions unchanged when all GSI values were included.

CONCLUSIONS: Higher symptom scores were associated with poorer quality of life. Findings are exploratory and do not establish diagnostic or causal relationships.

PMID:42881618 | DOI:10.3390/healthcare14193179

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