Relationship between psychological status and disease activity and quality of life in ankylosing spondylitis

Abstract

Our aim in this study was to compare the depression and anxiety risk in patients with AS and healthy controls and also to determine the relationship between disease activity, quality of life and psychological well-being. Two hundred and forty-three patients with ankylosing spondylitis (AS) and 118 age-, sex- and education-matched healthy controls were enroled into the study. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Functional Index, and Metrology Index, Health Assessment Questionnaire for Spondyloarthropathies (HAQ-S), Hospital Anxiety and Depression Scale (HADS) including depression subscale (HADS-D) and anxiety subscale (HADS-A), Ankylosing Spondylitis Quality of Life (ASQoL) Scale, duration of morning stiffness, pain-visual analogue scale (VAS), patient and physician's global assessment of disease activity (100 mm VAS) were used to assess clinical and psychological status. Patients had similar HADS-D but higher HADS-A than healthy controls. Patients with high risk for depression and anxiety had higher scores in BASDAI, BASFI and also poorer scores in VAS pain, patient global assessment, physician global assessment, HAQ-S and ASQoL. There was a negative correlation of HADS-D and HADS-A scores with educational level of the patients. Higher scores in HADS-D and HADS-A indicated poorer functional outcome and quality of life. Multivariate logistic regression analysis revealed that the HADS-D (OR=6.84), HAQ-S (OR=1.76), VAS pain score (OR=1.03) and ESR (OR=1.02) were independent risk factors for higher anxiety scores whereas HADS-A (OR=1.36) and ASQoL (OR=1.24) were independent risk factors for higher depression scores. The psychological status had close interaction with disease activity and quality of life in patients with AS.

Can Bath Ankylosing Spondylitis Disease Activity Index be Affected by Accompanying Fibromyalgia or Depression?

“…Previous studies investigating the relationship between depression and disease activity in AS have also revealed similar results. 22,23 As a result of our findings, we suggest that assessment of disease activity in patients with AS particularly by a patient-reported outcome measure such as BASDAI must include assessment of depression, which may potentially affect these scores. We recommend that treatment decisions and alterations should be made after treatment of accompanying depression if noted.…”

Anxiety, Depression, Problem Solving and Stress Management in Patients with Ankylosing Spondylitis

“…Previous studies have consistently shown significantly higher anxiety ve depression scores in AS patients compared to control groups. In one study using the HADS tool, Baysal et al (8) reported significantly higher anxiety scores among AS patients but no significantly difference in depression scores versus control group. Studies have looked at other parameters such as quality of life (6), disability (5), sexual dysfunction (25), and alexithymia (26) in addition to anxiety and depression and found considerable impairment in these areas.…”

“…Anxiety and depression are among the most commonly investigated psychiatric conditions among AS patients (5)(6)(7)(8)(9). Previous studies have consistently shown significantly higher anxiety ve depression scores in AS patients compared to control groups.…”

“…In another study, approximately one-third of AS patients reported a high level of depressive symptoms (7). Additionally, there are numerous studies that measured the quality of life as well as anxiety and depression in AS patients (5)(6)(7)(8)(9).…”

The Effectiveness of Exergames in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial

“…AS is an inflammatory condition that causes significant pain, functional disability and a diminished quality of life [1][2][3]. Combining exercise therapy with medication is standard for patients with AS, as suggested by the Spondylitis Association of America [4].…”