Background Ankylosing spondylitis (AS) is an inflammatory rheumatic disease characterized by spinal and/or peripheral involvement, enthesitis, dactylitis, and several extra-articular manifestations. Chronic inflammation often leads to reduced spinal mobility and functional disability. The frequency of fatigue, sleep disturbance, and psychological problems has increased in AS patients (1,2).

Objectives Although there are studies investigating depression and anxiety frequency in AS patients, different psychiatric disorders such as impulsivity, alexithymia and eating disorders have not been evaluated. The aim of this study is to investigate the frequency of different psychiatric disorders in AS patients, and to evaluate the relationship between these disorders with disease activity and functional status.

Methods Patients with AS (n=70) and healthy controls (n=56) were included in the study. The Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index (BASMI), pain visual analog scale, Beck depression scale, Beck anxiety scale, Barrat impulsiveness scale, Toronto alexithymia scale, Eating attitude test, fatigue, Ankylosing spondylitis quality of life, and Nothingam health profile were administered.

Results The frequency of depression, anxiety and non planning impulsiveness were higher in patients with AS than in healthy controls (p<0.05), although no difference was found in terms of alexithymia, fatigue, and eating attitude. Depression and anxiety were correlated with high disease activity, fatigue, impaired physical functioning, and lower quality of life in the patients with AS. Non planning impulsiveness was correlated with fatigue and lower quality of life while there was no correlation with disease activity and functional impairment. BASMI scores were not associated with psychiatric disorders.

Conclusions Depression and anxiety were associated with disease activation, while impulsivity frequency was increased independently of disease activity. Reducing in the quality of life and functional competence due to the psychiatric disorders indicates that, AS patients may require a psychological care approach during the follow up.

References

1. Anxiety and depression correlate with disease and quality-of-life parameters in Chinese patients with ankylosing spondylitis.Xu X, Shen B, Zhang A, Liu J, Da Z, Liu H, Gu Z. Patient Prefer Adherence(2016) 20;10:879–85. doi: 10.2147/PPA.S86612.

2. Relationship between psychiatric status, self-reported outcome measures, and clinicalparameters in axial spondyloarthritis. Kilic G, Kilic E, Ozgocmen S. Medicine (Baltimore) (2014) doi: 10.1097/MD.0000000000000337.

References

Disclosure of Interest None declared