Background Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease that may result in pain, functionally limitation and even less life expectancy. Psychological symptoms not only have a substantial negative impact on the quality of life, but also on the course and outcome of the chronic disorder . AS patients may also suffer from various sleep problems, and pain intensity, anxiety, and depression correlated significantly with poorer sleep quality . Stressful life events have a substantial association with psychological disorders, and there is some evidence indicating that even early life stress constitutes a major risk factor for the subsequent development of mental disorder .
Objectives Our study was to investigate psychological disorders, sleep disturbance and stressful life events in Chinese patients with AS, and to assess the correlation between each two disorders.
Methods AS patients diagnosed with the modified New York criteria for AS were enrolled from several provinces all over China. Participants were required to complete a set of questionnaires and examinations, including demographic and clinical information, Zung self-rating anxiety scale (SAS), Zung self-rating depression scale (SDS), the Social Readjustment Rating Scale (SRRS) and the Pittsburgh Sleep Quality Index questionnaire (PSQI). The Statistical Package for Social Sciences (SPSS) software version 21 was used for all data management and analysis. The relations between psychological variables, stressful life events, sleep quality and other parameters were examined with Spearman correlation analysis.
Results Of all the 2772 AS patients, 79.1% were male patients. 79.5% were employed. 48.4% were married. Mean age was 28.99±8.87. Mean disease duration was 6.84±6.78. Mean SAS score was 49.32±18.75. 31.6% of the patients had anxiety, of which 10.8% had severe anxiety. Mean SDS score was 54.97±16.67. 59.3% had suffered from depression, of which 11.3% had severe depression. Mean PSQI score was 6.48±4.32. 31.0% of the patients were poor sleepers. SRRS score was 129.33±145.06. 35.3% had stimulus of psychological and social elements (SPSE), while 14.4% came across severe SPSE. SAS scores were associated with age, age onset, SDS scores, SRRS scores positively and years of education negatively (P<0.01). SDS scores were associated with age, SAS scores, SRRS scores positively and years of education negatively (P<0.01). SRRS scores also correlated of less sleep efficiency (P<0.05).
Conclusions A large number of AS patients were found to have anxiety, depression, sleep disturbance and stressful life events. These problems correlated with each other. Clinicians should pay more attention to psychological disorders and sleep problems in AS patients.
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Disclosure of Interest Y. Jiang: None declared, M. Yang: None declared, Y. Zhang: None declared, Z. Liao: None declared, Z. Lin: None declared, Q. Lv: None declared, J. Qi: None declared, Q. Wei: None declared, S. Cao: None declared, J. Gu Grant/research support from: This project was supported by the National Natural Sciences Foundation of China (31070806), Clinical Subject (2007 and 2010) of Ministry of Public Health of China and from the Foundation of Guangdong province of China (2005A30801005 and 2008B080701086), State Board of Education Fund for the Doctoral (20060558046), Guangzhou Science and Technology Plan Projects (2006Z2-E0221) and 5010 Subject of Sun Yat-sen University (2009–2010)