Abstract
Objectives Axial spondyloarthropathy (axSpA) is a common rheumatic disease
in young people and has important physiosocial implications. The purpose of this
study is to examine the frequency of anxiety and depression in axSpA patients
and to check whether achieving inactive/low disease activity or taking
TNF inhibitors has a positive effect on anxiety/depression and quality
of life (QOL).
Methods 149 axSpA patients were examined cross-sectionally over a period
of two years. Baseline characteristics were recorded. Disease activity is
measured using the ASDAS-CRP index. The patients were evaluated in 2 groups
according to their disease activity, as inactive-low disease activity or
moderate-high disease activity. The treatments they received were analysed into
two groups as NSAIDs and TNF inhibitors. Anxiety and depression were assessed
using the Hospital Anxiety and Depression Scale (HADS). Quality of life was
measured with the EuroQOL (EQ5D).
Results 33.6% of all axSpA patients were diagnosed with probable
anxiety disorder and 47% with probable depression. These rates were
similar in inactive-low disease activity patients, with 38% for anxiety
and 32% for depression. While the incidence of anxiety and depression
did not change between patients with inactive- low disease activity and
moderate-high disease activity (for anxiety p=0.173 and for depression
p=0.375), there was also no difference between patients receiving TNF
inhibitor treatment and NSAIDs (p=0.149 and p=0.235).
Radiographic form of axSpA was predictive of probable anxiety and depression.
Peripheral arthritis is also predictive of probable depression.
Conclusion Although axSpA patients had inactive-low disease activity and
received TNF inhibitors, there was no significant reduction in the incidence of
anxiety and depression. In addition to controlling disease activity and
inflammation, regular psychosocial assessment should be part of the management
of axSpA patients.
Key words
anxiety - Axial-SPA - depression - QOL - inactive-low disease activity
Schlüsselwörter
Angst - Axial-SPA - Depression - QOL - inaktiv – geringe Krankheitsaktivität