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Depression, anxiety common in patients with axial spondyloarthritis
Patients with ankylosing spondylitis and nonradiographic axial spondyloarthritis showed a high risk for depressive symptoms and anxiety, a trend that varied by disease subtype and gender, according to study findings.
The study group included 316 patients confirmed to have either ankylosing spondylitis (AS) or nonradiographic axial spondyloarthritis (nr-axSpA) who were recruited from the Erciyes Spondyloarthritis Cohort. Researchers used a cross-sectional study design to assess patients’ VAS pain, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis Quality of Life questionnaire (ASQoL), and Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS-CRP) scores. They also evaluated the patients’ psychological status using the hospital anxiety and depression scale (HADS) with subscales for anxiety (HADS-A) and depression (HADS-D). Associations between psychological variables and clinical parameters were analyzed with multivariate logistic regression analysis adjusted for potentially confounding variables.
Of the 316 patients (142 nr-axSpA, 174 AS) studied, results revealed that 139 showed high risk for depression (HADS-D score ≥ 7) and 71 had a higher risk for anxiety (HADS-A score ≥ 10).
Patients with AS and nr-axSpA had similar HADS-D and HADS-A scores, but patients at high risk for depression and anxiety had higher scores in BASDAI, BASFI and ASDAS-CRP and scored more poorly in VAS pain and ASQoL, according to the researchers.
After multivariate logistic regression analysis, the researchers also found ASDAS-CRP, ASQoL, BASDAI scores and educational level were associated with the risk for depression, and ASQoL was associated with the risk for anxiety. Additionally, patients with lower levels of education were more likely to experience anxiety or depression, according to the researchers.
ASQoL and level of education were associated with the risk for both depression and anxiety, and disease activity (BASDAI and ASDAS-CRP) was an independent risk factor for depression but not anxiety in patients with axSpA. – by Shirley Pulawski
Disclosure: The authors have no relevant financial disclosures.