Article
Depressive symptoms are frequent, associated with disease activity, and affect quality of life in ankylosing spondylitis: A questionnaire-based assessment of 300 patients
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Published: | October 8, 2019 |
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Background: Depression constitutes an increasingly recognized comorbidity of inflammatory joint conditions. Both, depression and anxiety have been shown to reduce likelihood of joint remission and depressive symptoms may contribute significantly towards morbidity and mortality. Here, we sought to determine factors associated with signs of depression and quality of life.
Methods: A questionnaire was used to assess 150 patients with ankylosing spondylitis (AS) as well as 150 patients with chronic mechanical back pain for quality of life (QOL), signs of depression and associated factors (BASDAI, BASFI, FFbH, WHOQOL-BREF, Phq9, GHQ-12).
Results: We have assessed 150 patients with confirmed AS as well as 150 patients with chronic mechanical back pain for quality of life and signs of depression. Physical health-related QOL as well as psychological wellbeing was reduced in both groups compared to published normal values for healthy donors. 36%, respectively 41% of AS and back pain patients had moderate to severe depressive symptoms. Female AS patients had a significantly lower physical and psychological health-related QOL as well as satisfaction with health than male AS patients (p=0.003, 0.002, respectively 0.015). Female AS patients also had significantly more depressive symptoms (p=0.005). There were no significant differences between smokers and non-smokers. Body mass index did not correlate with QOL or depressive symptoms. Age was negatively correlated with perceived QOL and functional impairment in everyday life (both p<0.001), however not with depressive symptoms (p=0.730). Pain level assessed on visual analogue scale was negatively correlated with perceived QOL, physical and psychological health-related QOL, social relationships and environment (all p<0.001). Furthermore, pain also correlated with depressive symptoms (p<0.001). Also, disease activity (BASDAI score) was highly correlated with perceived QOL, physical and psychological health-related quality as well as depressive symptoms (all p<0.001).
Conclusion: Depression constitutes an important comorbidity of AS, which needs to be addressed. Adequate therapy is not only important to reduce irreversible joint damage and disability but may also have a role in avoiding comorbidities such as depression.