Background Clinical depression has been reported to be frequent in anyklosing spondylitis (AS) (1). However, data about the relationship to disease activity are lacking. Zung self-rating depression scale (ZSRDS) is a recognized questionnaire for the assessment of depression and anxiety (2). SF 36 is a common tool used to assess physical and mental status in rheumatic diseases; however its ability to discern symptoms of depression is undefined. This study compares the efficiency of SF36 and ZSRDS to recognize symptoms of this disorder in a cohort of AS patients, assesses the occurrence of depression in AS patients, its correlation to disease activity and compares its frequency with psoriatic arthritis (PsA) patients' cohort.
Objectives (1) to find out the occurrence of depression in our patients with AS (2) to compare the yield of a specific ZSRDS and individual domains of SF-36in the detection of the depression in AS patients (3) to find out the correlation of the depression with some demographic and clinical data of AS patients (4) to compare the occurrence of depression among patients with AS and PsA.
Methods For the assessment of depression ZSRDS was used, For the assessment of clinical activity BASDAI (VAS 0-100 mm) was used. The occurrence of depression was compared with patients with (PsA) (n=101). This is a cross-sectional study. Association of depression according to ZSRDS with nominal and continuous/ordinal variables was assessed using Mann-Whitney U test and Spearman rank correlation, respectively.
Results In total 260 with AS were examined, 227 (87.3%) on biologic therapy. Age-mean (SD) was 42.0 (10.9) years, disease duration-mean (SD) 13.0 (9) years. BASDAI was 21 (17), CRP 7.2 (12.2). 11 pats. had preexisting psychiatric diagnosis (4.2%). 8 pats. (3.1%) were on antidepressants. (1)The occurrence of depression according to ZSRDS was in 13 pats. (5%), 12 (4.6%) with mild depression and 1 (0.4%) with moderated depression. (2) The correlation of ZSRDS (SDS) with SF-36 mental health (MH) was -0.723 (<0.001), with vitality (VT) was -0.708 (<0.001), with social functioning (SF) was -0.555 (<0.001), with bodily pain (BP) was -0.547, with role physical (RP) was -0.520 (<0.001) and with role emotional (RE) was -0.501 (<0.001). (3) Depression significantly correlated withdisease activity-(BASDAI (0.489, p<0.001), CRP (0.184 p<0.003), age (0.263 p<0.001). Correlation with disease duration and sex was not significant. The occurrence of depression in PsA patients was 10.9%
Conclusions The occurrence of depression in our AS cohort is relatively low probably due to low disease activity
Zung Self Rated Depression Scale correlates well with some domains of SF-36 mental mainly health and vitality
The presence of depression correlates well with disease activity clinically (BASDAI) as well as laboratory (CRP)
The occurrence of depression in AS patients was half of those with PsA
Meesters JJ et al: The risk for depression in patients with ankylosing spondylitis: a population-based cohort study. Arthritis Res Ther 2014;16(5):418.
Zung WWK: A self-rating scale for depression. Archives of General Psychiatry 1965;12:63-70.
Acknowledgements Supported by the Research program of the Ministry of health of Czech Republic: IGA MZ CR: No. 000 000 23728
Disclosure of Interest None declared