Article Text

SAT0267 Is the Widely-Used Score in Axial Spondyloarthritis, Basdai (Bath Ankylosing Spondylitis Diseases Activity Index), Influenced by Patients' Optimism? a Cross-Sectional Study of 206 Patients
  1. S. Fabre1,2,
  2. A. Molto3,
  3. S. Kreis1,
  4. S. Dadoun1,4,
  5. C. Rein1,4,
  6. C. Hudry5,
  7. B. Fautrel1,4,
  8. E. Pertuiset2,
  9. L. Gossec1,4
  1. 1UPMC Univ Paris 06, GRC-08, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, paris
  2. 2Rheumatology, René Dubos hospital, Pontoise
  3. 3Rheumatology, Paris Descartes University, Cochin Hospital, AP-HP. INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité
  4. 4Rheumatology, AP-HP, Pitié Salpêtrière Hospital
  5. 5Rheumatology, Office-based practice, paris, France


Background The Bath Ankylosing Spondylitis Diseases Activity Index (BASDAI) is widely used to assess disease activity in axial spondyloarthritis (axSpA) and is a criterion for initiating anti-TNF therapy. Psychological distress (anxiety/depression) may be related to BASDAI scores (1), which may be an issue when using the BASDAI to decide on treatment strategies. Do stable personality traits like dispositional optimism-a general positive mood or attitude towards the future-also influence BASDAI results?

Objectives To determine if BASDAI scores are influenced by optimism in axSpA.

Methods A cross-sectional study was performed in two tertiary care hospitals and one office-based practice in France (2). Patients had definite axSpA according to the rheumatologist. Auto-questionnaires included the BASDAI and optimism, evaluated through the French version of the Life Orientation Test-Revised (LOT-R) (3). The LOT-R consists of 10 questions:the score ranges from 0 (low optimism) to 24 (high optimism). Analyses included Spearman correlation and multivariate regression analyses to explain BASDAI based on optimism, adjusted on demographic variables and anxiety/depression, evaluated through the Hospital Anxiety and depression scale (HADS).

Results 206 patients were included: mean age, 46.3 years, 49.0% were men. Mean disease duration was 15.5±10.8 yrs, mean BASDAI (0-10) was 3.8±2.0. Optimism was low to moderate: mean LOT-R score was 13.7±4.3. Optimism was significantly though slightly correlated to BASDAI scores: R=-0.15, p=0.04. However, in the multivariate analysis, there was no significant relationship between BASDAI and optimism.

Conclusions Optimism was not associated to BASDAI scores in multivariate analyses. This result confirms that BASDAI is a valid tool, which can be interpreted independently of patients' personality traits like optimism. This result is reassuring in view of the reports of a relationship between anxiety/depression and BASDAI. However, optimism is a stable personality trait through life whereas anxiety and depression are variable psychological states. More work is needed on the best ways to analyse SpA activity; in particular ASDAS should be further evaluated.


  1. Brionez TF, et al. Psychological Correlates of Self-Reported Disease Activity in Ankylosing Spondylitis. J Rheumatol 2010; 37:829-34.

  2. Fabre S, et al. Do Patients with Axial Spondyloarthritis (AxSpA) Perform Enough Physical Activity? a Cross-Sectional Study of 207 Patients. Arthritis Rheum 2014, 66(suppl):S1125.

  3. Scheier MF et al. Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A re-evaluation of the Life Orientation Test. J Pers Soc Psychol 1994, 67:1063-78.

Disclosure of Interest None declared

Statistics from

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.