[Depression and Anxiety in Spondyloarthritis: Prevalence and Relationship with Clinical Parameters and Self-Reported...

To assess the prevalence of depression and anxiety among patients with spondyloarthritis.

One hundred patients with spondyloarthritis attending the rheumatology outpatient unit were enrolled. Duration of morning stiffness, pain/fatigue visual-analogue-scale, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Functional Index, Metrology Index, Patient Global Score, Hospital Anxiety and Depression Scale (HADS) including depression subscale (HADS-D) and anxiety subscale (HADS-A), Ankylosing Spondylitis Quality of Life (ASQoL) Scale, Short Form 36 Health Survey and Functional Assessment of Chronic Illness Therapy-Fatigue-Scale were used to assess clinical and psychological status.

The HADS-D and HADS-A scores revealed that 31% of the patients were depressed and 39% had anxiety. Multivariate logistic regression analysis revealed that a VAS fatigue >50, morning stiffness >15minutes, BASDAI >4, BASFI >4, BAS-G >50 and high FACITFatigue scale were independent risk factors associated with the risk of both depression and anxiety. A visual-analogue-scale pain >50 was an independent risk factor for only depression. Female gender, disadvantaged social class and MCS <50 seemed to be the independent risk factors associated only with anxiety.

Association of SpA with anxiety and/or depression appear multifactorial including both personal and disease-related factors. Early identification of depressive and anxiety disorders may allow early referral for psychiatric assessment, educational programs and psychopharmacological treatment.