P099 Progression of psychological distress in inflammatory arthritis patients

Abstract Background/Aims Patients with inflammatory arthritis (IA) often present with mental health concerns at the time of diagnosis. Yet, the onset and progression of these psychological challenges throughout the disease’s trajectory remain unclear. Gaining insights into the evolution of mental health issues is crucial, as they can potentially lead to suboptimal disease management, amplified pain experiences, and a diminished quality of life. Our objective was to assess mental health co-morbidity and fibromyalgia severity status in patients with inflammatory arthritis before diagnosis, immediately after, and six months post-diagnosis in order to trace the natural progression of these conditions over time. Methods In this prospective observational study, we collected mental health (GAD7 for anxiety, PHQ8 for depression) and fibromyalgia criteria measures (WPI: Widespread pain index, SSS: symptom severity score) pre-diagnosis (via online form whilst awaiting initial appointment), immediately following diagnosis and six months post-diagnosis. Eligibility criteria were subsequent diagnosis of IA and pain rating ≥3/10 at Guy’s Hospital, London. In addition, demographic data and clinical assessment (DAS28, pain score) were collected immediately following diagnosis. Results 20 patients were recruited between April and November 2022. 50% were female, 65% had RA, and mean age was 51±14 years. Mean DAS 28 was 3.7 ± 1.1, mean fatigue score 39/100 ±31 and mean pain score was 5.3/10 ± 2.1. Mean MSK HQ was 31.2 ±12.7 and mean RAID was 3.9 ±2.5. The time from diagnosis to post-diagnosis assessment averaged 1.6 ±3.4 months, while from pre-screen to post-diagnosis assessment it was 2.9 ±3.7 months. Immediately following diagnosis, 10 patients (50%) screened positive for anxiety and 11 (55%) for depression. Anxiety significantly increased following diagnosis, and then returned to pre-diagnosis levels at six months. Depression and fibromyalgia severity remained similar to pre-screen following diagnosis, but at six months had significantly dropped from pre-screen levels (Table 1). Conclusion Rates of mental health comorbidity in IA at diagnosis are high. Receiving a diagnosis of IA may contribute to heightened anxiety, which reduces again by six months. Depression symptoms and fibromyalgia severity, including widespread pain, remain high following diagnosis but improve after six months, possibly as disease activity improves. Disclosure Z. Rutter-Locher: None. N. Arumalla: None. S. Norton: None. T. Garrood: None. L. Taams: None. K. Bannister: None. B. Kirkham: None.