Background Depression and anxiety are more prevalent in chronic diseases compared to the normal population1. In patients with ankylosing spondylitis (AS), unrecognised depression and/or anxiety is likely to lead to worse outcomes and suboptimal responses to AS treatments. Screening patients for anxiety and depression should improve our understanding of patients’ disease and help to tailor AS treatments
Objectives To assess the prevalence of anxiety and depression amongst AS patients and to correlate these conditions with patient reported outcomes.
Methods In January 2012 we set up annual review clinics for patients with AS. Amongst screening for other comorbities we looked at Hospital Anxiety and Depression Scores (HADS-A and HADS-D respectively). We also looked at the BATH indices (BADAI, BASFI, BAS-G and Spinal Pain VAS), employment status, obesity, smoking and excess alcohol consumption and correlated these to HADS results.
Results 59 patients attended (M=41, F=18) and completed HADS and BATH patient self assessments (BASDAI, BASFI, BAS-G, Spinal Pain VAS).
19 patiients had high anxiety scores (M=15, F=4) and 24 had high depression scores (M=17, F=7). 16 patients scored high on both anxiety and depression scales (M=12, F=4).
High BASDAI scores were positively correlated with anxiety (p<0.0001) and depression (p<0.0007). Similarly BASFI (p<0.002, p<0.0002), BASS-G (p<0.0005, p < 0.00002) and Pain VAS (p<0.002, p<0.04) scores correlated with anxiety and depression. There was a correlation between and unemployment and depression (p<0.04) but not with anxiety (p>0.2). Obesity was also not correlated to anxiety but was to depression (p<0.04). Smoking or alcohol excess were not linked to increased HADS.
Conclusions Both anxiety and depression were prevalent in this patient group. Worse patient reported outcomes were noted in the presence of anxiety or depression. Recognising and treating anxiety and depression in AS is an important part of their management. Yearly review clinics are best suited to considering these chronic disease associations and discussing therapeutic options
Bayat N et al. Symptoms of anxiety and depression: A comparison among patients with different chronic conditions. J Res Med Sci. 2011 November; 16(11): 1441–1447
Disclosure of Interest None Declared