[Psychological classification of patients with ankylosing spondylitis]

Ankylosing spondylitis - (AS-)patients are reported being characterized by marked ego strength and a stable personality. The aim of the present study was to investigate if they can be differentiated into subgroups which suggest different indications for training psychological skills to cope with their disease. Constructs which were thought to be relevant for psychological pain treatment were: disease activity, irrationality, positive and negative self-communication, stress-reactions, and disease impacts. For each construct factorial values were calculated from indicator variables to classify the patients. Subjects were 197 patients with a long-standing diagnosis of AS, who were treated in a specialized theumatological treatment unit in the Karl-Aschoff-Klinic, Bad Kreuznach, Germany. A hierarchical-agglomerative cluster-analyses suggested five subgroups with a reclassification rate of 91%. 10.2% of the patients were marked by elevations on all negative scales (including disease activity) and low values on the positive self-communication scales. Further 28% showed low disease activity but high disease impacts (affective pain, general health condition). For both groups different indications for learning to cope with disease impacts were suggested. 60.8% of the patients demonstrated themselves to be good copers. Of special interest were 11.8% of all patients who reported high disease activity but low disease impacts and low positive self-communication. Two other subgroups differed only in the level of the variables-profile.