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Missing pebble in the mosaic of rheumatic diseases and mental health: younger does not always mean happier
  1. Alessia Alunno1,
  2. Paul Studenic2,
  3. Dieter Wiek3,4,
  4. Petra Balážová5,6,
  5. Daniel Aletaha2
  1. 1 Rheumatology Unit, Department of Medicine, University of Perugia, Perugia, Italy
  2. 2 Division of Rheumatology, Department of Internal Medicine 3, Medical University Vienna, Vienna, Austria
  3. 3 EULAR PARE, Zurich, Switzerland
  4. 4 Deutsche Rheuma-Liga, Bonn, Germany
  5. 5 EULAR Young PARE, Zurich, Switzerland
  6. 6 Slovak League Against Rheumatism, Piestany, Slovakia
  1. Correspondence to Dr Alessia Alunno, Rheumatology Unit, Department of Medicine, University of Perugia, Perugia I-06129, Italy; alessia.alunno82{at}

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We have read with great interest the article by Redeker et al 1 investigating the determinants of psychological well-being in axial spondyloarthritis (SpA). The authors observed that among 1736 patients aged 18–79 years, 68% of subjects displayed depressive symptoms, ranging from mild to severe according to the five-item WHO Well-Being Index. This article clearly points out the burden of depressive symptoms in patients with SpA and its correlation with disease activity, functional impairment and other parameters including younger age. The authors emphasise that a potential explanation for the negative association between depressive symptoms and age might be a better capability to cope with the disease of adult compared with young patients. This aspect prompted our reflections, as the psychological impact of rheumatic and musculoskeletal diseases (RMDs) in young people is a major unmet need.

We previously reported that over 90% of young patients with RMDs outline an impact of their condition on mental health which, …

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