Depression and Quality of Life in Patients with Rheumatoid Arthritis: The Impact of Self-Disgust

Background: Rheumatoid arthritis (RA) significantly impairs patients’ quality of life. Psychological factors such as depression and self-disgust have been shown to be associated with quality of life; however, their interactions and combined effects remain unclear. Moreover, the level of self-disgust among Chinese patients with RA has not yet been investigated. Objective: To examine the mediating effects of self-disgust in the relationship between depression and quality of life among patients with RA, and to provide a reference for clinical practice aimed at improving patients’ quality of life. Methods: This cross-sectional study was conducted at a tertiary general hospital in Guangzhou between August 2024 and February 2025, involving 342 patients with RA. Participants completed the General Information Questionnaire, the Questionnaire for the Assessment of Self-Disgust (QASD), the Hospital Anxiety and Depression Scale (HADS) and Quality of Life in RA Patients Scale. Univariate and Pearson correlation analyses were performed using SPSS 27.0, and mediation effects were tested with the Process plugin. Results: The mean scores of depression, the Quality of Life in RA Patients Scale and QASD were (9.01± 4.97), (82.23± 16.73) and (27.58± 13.67), respectively. Depression was significantly correlated with quality of life ( r =0.787, P < 0.001), depression was significantly correlated with self-disgust ( r =0.804, P < 0.001), and quality of life was significantly correlated with self-disgust ( r =0.727, P < 0.001). Self-disgust exhibited a partial mediating effect on the relationship between depression and quality of life in patients with RA, accounting for 20.60% of the total effect. Conclusion: Patients with RA have a relatively low quality of life. Self-disgust plays a partial mediating role between depression and quality of life in patients with RA. Nursing staff should pay attention to the assessment and screening of patients’ depression and self-disgust, and implement targeted interventions to improve patients’ quality of life. Keywords: RA, self-disgust, depression, quality of life, mediating effect