Correlation of Axial Spondyloarthritis with Anxiety and Depression

BACKGROUND This study compared anxiety and depression in patients with nonradiographic axial spondyloarthritis (nr-axSpA) versus patients with ankylosing spondylitis (AS), and examined the relationship between clinical characteristics and psychological status. MATERIAL AND METHODS Patients diagnosed with axial spondyloarthritis (axSpA) were recruited for the study. Disease status was evaluated by the bath ankylosing spondylitis disease activity index (BASDAI), the bath ankylosing spondylitis functional index, visual analog scale, and the level of inflammatory markers. Psychological status was evaluated by the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS). RESULTS Sixty patients with axSpA were enrolled in the study, including 40 patients with AS and 20 patients with nr-axSpA. Patients with AS and patients with nr-axSpA had similar disease status and psychological status. Anxiety was significantly associated with disease status and SDS score (P<0.05 for all), whereas BASDAI (odds ratio [OR]=0.28, 95% CI=0.08-0.97, P=0.045) and SDS (OR=0.90, 95% CI=0.82-0.98, P=0.014) protected against anxiety. Depression was obviously correlated with smoking history, disease status, and SAS score (P<0.05 for all). Smoking history (OR=10.18, 95% CI=1.23-84.23, P=0.031) and SAS score (OR=0.85, 95% CI=0.75-0.97, P=0.014) were negatively correlated with risk of depression. CONCLUSIONS Patients with AS and patients with nr-axSpA had similar psychological status in terms of anxiety and depression. Disease status and smoking were significantly correlated with psychological status. Patients with higher SAS scores were more likely to have depression. The results of this study may be helpful to clinically guide psychological interventions for patients with axSpA.