Verstappen SMM et al. (2007) Functional health assessment questionnaire (HAQ) and psychological HAQ are associated with and predicted by different factors in rheumatoid arthritis. J Rheumatol 34: 1837–1840

The health assessment questionnaire (HAQ) is commonly used to assess the functional disability of patients with rheumatoid arthritis (RA), whereas the psychological HAQ (PSHAQ) has been developed to evaluate psychological distress in these patients. Verstappen et al. evaluated the association between clinical, demographic, functional and psychological factors and the HAQ and PSHAQ scores in a group of 112 patients with RA; the authors also assessed whether any of the factors evaluated at diagnosis were predictive of HAQ or PSHAQ score later on.

At diagnosis, clinical variables (erythrocyte sedimentation rate, Thompson joint score, visual analog score [VAS] for pain and for general well-being, and morning stiffness) and domains of psychological distress including anxiety were assessed; patients also completed the Dutch Health Assessment Questionnaire (VDF), a derivation of the original HAQ, at this time. The same clinical variables were assessed at follow-up (7.1 ± 3.4 years) at which time both HAQ and PSHAQ scores were obtained.

HAQ score was associated with all clinical variables at diagnosis and at follow-up. By contrast, PSHAQ score at follow-up was associated only with subjective patient-related clinical variables (VAS pain, VAS general well-being, and morning stiffness). In multivariate regression analyses, only functional disability (VDF score) at diagnosis was predictive of HAQ score at follow-up. Anxiety, but no clinical variable, assessed at diagnosis was predictive of PSHAQ score at follow-up.

The authors conclude that, in contrast to PSHAQ, HAQ score is a good indicator of disease activity at diagnosis and 7 years later in patients with RA.