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In their letter ‘A missing pebble in the mosaic of rheumatic diseases and mental health: younger does not always mean happier’,1 Alunno et al commented on our recent publication2 and raised the issue of determinants of psychological well-being in different age groups of persons with axial spondyloarthritis (axSpA). We very much appreciate their interest in our study and valuable comments made and would like to address the raised issues here in more details.
In our study, we investigated determinants of psychological well-being in persons with axSpA using the five-item WHO Well-Being Index (WHO-5), a sensitive and specific screening tool for depression. We found that among 1736 persons with axSpA aged 18–79 years only 42% had a good well-being, whereas 28% had mild depressive symptoms and 31% even had moderate-to-severe depressive symptoms.2 In the linear regression model, we found a negative association between age and the odds of having moderate-to-severe depressive symptoms. Interestingly, a closer …
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