Background Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is a standard instrument regularly used to assess disease activity of patients with spondyloarthritis (SpA). However, the well-being of a patient is also affected by impairment of function as well as psychological status especially depression and anxiety.
Objectives The aim of this study was to investigate the relationship between disease activity measured by the BASDAI and psychological variables.
Methods This was a cross-sectional study at a rheumatology department over a twelve months period. Patients with diagnosis of SpA (ASAS 2009) were recruited. Respectively, disease status and psychological status were assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Hospital Anxiety and Depression Scale (HADS). A statistical analysis was performed.
Results A total of 100 patients were enrolled; mostly male (71%). The mean age of the sample was 41,72 (±13,57) years; the mean disease duration at study baseline was 11,87 (±10,3) years. Mean morning stiffness 30,26 minutes. The mean score on VAS pain was 60,3mm (±28,66). At baseline, the mean BASDAI score was 4,5 (±2,3); 57% have BASDAI greater than or equal to 4. The mean (SD) scores by the study participants on the HADS-Anxiety (HASD-A) and HADS-Depression (HADS-D) were 8,9 (±5,08) and 7,23 (±5,27), respectively. The prevalence of anxious symptomatology based on the HADS-A was 39%, 18% were classified as possible anxiety cases. Based on HADS-D scores, 31% of the patients presented symptoms of depression and 15% possible depression.
BASDAI was positively correlated with both HADS-D (r=0.505, p<0.0001) and HADS-A (r=0.425, p<0.0001). The multivariate logistic regression analysis revealed that patients' whose BASDAI>4 at baseline was an independent risk factor associated with the risk of both depression (OR=4.9, 95%CI [1.7–13.9], p=0.002) and anxiety (OR=2.7, 95%CI [1.1–6.7], p=0.027).
Conclusions This study underscore that high disease activity increased significantly the risk of depression and anxiety in SpA.
Disclosure of Interest None declared