Article Text

Download PDFPDF

  1. G. Ayan1,
  2. B. Farisoğullari1,
  3. E. Bilgin1,
  4. E. C. Bolek1,
  5. G. K. Yardimci1,
  6. E. Duran1,
  7. Z. Özsoy1,
  8. G. Sandal Uzun1,
  9. L. Kiliç1,
  10. A. Akdoğan1,
  11. O. Karadag1,
  12. Ş. A. Bilgen1,
  13. S. Kiraz1,
  14. A. İ. Ertenli1,
  15. U. Kalyoncu1
  1. 1Hacettepe University Medical Faculty, Department of Internal Medicine Division of Rheumatology, Ankara, Turkey


Background: Anxiety is commonly observed, underestimated problem in patients with psoriatic arthritis (PsA). Overall rate has been reported around 20% [1]. However the data on anxiety in PsA patients requiring advanced treatment and change in response to therapy is scarce.

Objectives: Our aim was to understand the frequency of anxiety before starting biologic agents and change in the anxiety scores with the treatment.

Methods: PsA patients from the Hacettepe University biological database (HUR-BIO) were assessed for anxiety (score ≥ 4) using the patient self-reported measure of anxiety on a 0-10 numerical scale, included in the Psoriatic Arthritis Impact of Disease questionnaire (PSAID-12) [2]. The anxiety rate and scores were determined before starting biologic agents and at first visit in 6 months. Change in the scores were compared between patients according to the favourable treatment responses (Table 1). The correlation between the score-changes in anxiety and treatment response parameters was assessed by spearman correlation analysis.

Results: From 520 patients registered, 147 [mean (SD) age 43.3 (12.4) years, 70.7% female] had anxiety score registered both at baseline and first visit in 6 months. Both the frequency and mean (SD) score of anxiety decreased at first visit [63.9% vs 41.4 %, 4.8(3.4) vs 3.2 (3.1) respectively, p<0.001 for both] after a mean (SD) follow-up of 105.7 (22.2) days. There was a statistically significant difference between changes in the anxiety scores in patients with/without treatment responses in pain, PGA, BASDAI, HAQ-DI and DAS-28. A positive correlation between the change in anxiety and all treatment response parameters was observed (Table 1, Figure 1).

Table 1.

Patient characteristics at baseline and changes in the anxiety score according to treatment response

Conclusion: Anxiety is a more frequent problem at the time of biologic initiation compared to rates observed in general PsA population which could be related to the high disease activity. The rates are still high in 6 months under treatment, however both the frequency and score of anxiety showed a decreasing trend parallel to the treatment response.

References: [1]Zusman EZ, Howren AM, Park JYE,et. al (2020) Epidemiology of depression and anxiety in patients with psoriatic arthritis: A systematic review and meta-analysis. Semin Arthritis Rheum 50 (6):1481-1488.

[2]Gossec L, de Wit M, Kiltz U, Braun J, et al (2014) A patient-derived and patient-reported outcome measure for assessing psoriatic arthritis: elaboration and preliminary validation of the Psoriatic Arthritis Impact of Disease (PsAID) questionnaire, a 13-country EULAR initiative. Ann Rheum Dis 73 (6):1012-1019.

Figure 1.

Correlation between the score changes

Disclosure of Interests: None declared.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.