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

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.