For the present study 34 rheumatic patients with different diseases (RA, spondyloarthritis, SLE, other connectivitis, vasculitis) were recruited thanks to the collaboration with the italian patient association ReumAmici. This association owns a website that patients can join and therefore participate in the community activities, especially in communicating through a patient web forum.

Four different questionnaires exploring physical and mental health were administered to all patients at time 0 (before joining the website) and after 3 months of active and continuous participation to the community activities: SF-36, HAQ, Zung self-rated anxiety scale and Zung self-rated depression scale. All the questionnaires were submitted by email and self-reported by the patients.

SF-36 questionnaire ₁₃ was used to evaluate the Quality of Life (QoL) of the patients. This survey contains 36 questions that evaluate eight health domains in both physical health and mental health. These eight domains are physical functioning (PF, ten items), social functioning (SF, two items), role limitations caused by physical problems (RP, four items), role limitation caused by emotional problems (RE, three items), mental health (MH, five items), energy and vitality (VT, four items), pain (BP, two items), and general perception of health (GH, five items). For each item score are collected and transformed to a scale from 0 (worst possible health state) to 100 (best possible health state). The italian form of SF-36 questionnaire was used ₁₄.

HAQ questionnaire ₁₅ was used to assess physical function of the patients. This questionnaire was developed as a comprehensive measure of outcome in patients with a wide variety of rheumatic diseases including RA, osteoarthritis, SLE, ankylosing spondylitis, fibromyalgia and psoriatic arthritis. The HAQ contains 20 items distributed across 8 components. The scores for each item range from 0 (without any difficulty) to 3 (unable to do). The highest score on any item within one component represent the dimension score. The patient also indicates wether he or she uses aids or devices or help from other individuals. The scores for each dimension are corrected for the use of aids or devices, summated, and transformed to give an overall disability index (DI) score between 0 (no disability) and 3 (very severe disability). The italian form of HAQ questionnaire was used ₁₆.

The Zung self-rating anxiety scale ₁₇ was used to assess level of anxiety of the patients. It is a 20-item scale, with some of the items keyed positively and some negatively. The items are answered on a four-point scale ranging from 1 (none or a little of the time) to 4 (most or all of the time). The final score range from 20 to 80. A score between 20 and 44 is considered in the normality range, while a higher score indicate at least mild-moderate symptoms of anxiety. Italian translation of the original scale was used.

The Zung self-rating depression scale ₁₈ was used to assess level of depressive symptoms of the patients. It is a self-reported 20-item scale, where items responses are ranked from 1 (none or little of the time) to 4 (most or all of the time). Some of the items are worded positively and other are worded negatively. The final score range from 25 to 100. A score between 25 and 49 is considered in the normality range, while a higher score indicate the presence of at least mild-moderate depressive symptoms.

Data in table are presented as mean ± standard deviation. Paired t-test was used to compare the scores before and 3 months after joining the web-community. A P-value of <0.05 was considered significant.