Background AS is a disease with a heavy psychological burden1, its main clinical characteristics having a profound impact on health related quality of life (HRQoL)2.
Objectives To study the correlations between personality types, health related quality of life (HRQoL) and disease activity in SA, few data being available regarding these aspects.
Methods This cross-sectional study included 90 AS pts from two different Rheumatology Departments (75.6% men, 24.4% women, mean age 43.63, mean duration of disease 12.7 years). Personality types were assessed with Jenkins Activity Survey (JAS-13) for type A/B, State-Trait Anger Expression Inventory Anger-in Scale (AIS) for type C and Type D Personality Scale (DS-14), with its subcomponents (negative affect-NA and social inhibition-SI) for type D. HRQoL was evaluated using the Medical Outcome Study Short-Term-36 (SF36v2), analyzing correlations with all subscales (Physical function-PF, Social function-SF, Role physical-RP, Role emotional-RE, Mental health-MH, Vitality-VT, Bodily Pain-BP, Global Health-GH, physical component scores-PCS and mental component scores-MCS). Disease activity was assessed with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Analyses were performed using Pearson's correlation coefficients and independent samples t-tests.
Results Type C pts have lower values of HRQoL components than non-type C (BP t(85)=-2.09, GH t(85)=-2.33, VT t(84)=-2.5, RE t(84)=-2.46, MH t(84)=-2.73, MCS t(84)=-2.61). AIS scores are negatively correlated with all SF36 components (PF r=-0.25, RP r=-0.3, BPr=-0.25, GH r=-0.45, VT r=-0.46, SF r=-0.28, RE r=-0.31, MH r=-0.49, PCS r=-0.26, MCS r=-0.42). Furthermore, type C characteristics increased proportionally with BASDAI values (r=0.33). The same negative tendency was noticed for type D pts, with lower overall values for HRQoL (PF t(85)=-1.98, RP t(68.45)=-2.83, BP t(85)=-2.22, GH t(85)=-3.57, VT t(84)=-3.89, SF t(85)=-2.89, RE t(49.77)=-4.2, MH t(84)=5.51, MCS t(84)=-5.2). Furthermore, type D was found to be inversely proportional with HRQoL, where NA was separately correlated with PF r=-0.41, RP r=-0.38, BP r=-0.39, SF r=-0.47 and PCS r=-0.35, and both type D components (NA and SI) correlated with the other HRQoL components (GH rNA=-0.57, rSI=-0.32; VT rNA=-0.61, rSI=-0.35; RE rNA=-0.49, rSI=-0.31; MH rNA=-0.67, rSI=-0.47; MCS rNA=-0.61, rSI=-0.39). Type D individuals have higher BASDAI t(84)=2.42, and type D characteristics increase proportionally with BASDAI (rNA=0.4, rSI=0.22). When compared to type B, type A pts had overall better physical scores and lower disease activity levels.
Conclusions Type C and D personalities were found to be strongly correlated with decreased HRQoL and with higher disease activity levels, whereas type A was related to positive results in AS pts. The hypothesis that personality types could influence HRQoL in treatment outcomes should be further analyzed.
Martindale J, et al. Rheumatol. 2006;45(10):1288-1293.
Baysal Ö, et al. Rheumatol International. 2011;31(6):795-800.
Disclosure of Interest None declared