Background According to modern conception “T2T” a patient with ankylosing spondylitis (AS) takes an active part in the disease treatment that determines the importance of his psychological state.
Objectives To evaluate interconnection between the psychological state of the patient with AS and the disease course.
Methods Within the regional registry which is a part of epidemiological study of clinical diversity of AS in Russian population, 40 patients (32 males and 8 females) at the age of 21 to 56 years (average age 40,3±10,0) were examined. The average disease duration on the day of examination was 12,7±9,9 years, BASDAI - 5,54±1,8, BASFI – 5,34±2,48. Functional status (range of motion) was evaluated by means of BASMI. EQ-5D questionnaire was used for psychological state evaluation.
Results A total of 17 (42,5%) patients had anxiety and depression: moderate – 15 (88,2%), severe – 2 (11,8%) responders. With the disease duration of less than 5 years propensity for depression and anxiety was noted by 6 out of 11 (54,5%) patients, 5 to 10 years – 2 out of 12 (16,7%), more than 10 years – 9 out of 17 (52,9%).
In patients with mild disease activity anxious and depressive states were not observed, with moderate disease activity they were revealed in 3 out of 7 patients (42,8%), with severe activity – in 9 out of 21 (42,8%), with very severe activity – in 5 out of 10 (50%) responders.
Among the patients without limitation of motion (BASFI) anxiety and depression was revealed in 2 out of 11 (18,2%), with moderate limitation –6 out of 18 (33,3%), with severe limitation –9 out of 11 (81,8%) patients. According to BASMI 1 out of 2 patients without limitation of motion had anxiety and depression, 6 out of 19 (31,5%) – with moderate limitation and 10 out of 19 (52,6%) with severe limitation. The direct correlation was revealed between EQ-5D score and BASFI (r=0,996) and between EQ-5D and BASDAI (r=0,855), concurrently such correlation was absent between BASMI and EQ-5D.
Among the patients without anxious and depressive states 14 out of 23 (60,8%) patients take NSAIDs regularly while among the patients who noted propensity for anxiety and depression only 7 out of 17 (41,17%) take NSAIDs regularly.
Conclusions Patients with short (less than 5 years) and long (more than 10 years) AS duration, severe disease activity and functional limitation are more prone to anxiety and depression. Patients with anxious and depressive states are less compliant with therapy which influences its efficacy. These data should be considered when the programs of AS patients' management are developed.
Disclosure of Interest None declared