Department of Medicine, Division of Rheumatology, University of Texas Health Science Center at Houston, Houston, Texas 77030, USA.
J Rheumatol. 2010 Apr;37(4):829-34. doi: 10.3899/jrheum.090476. Epub 2010 Feb 15.
To investigate the role of psychological variables in self-reported disease activity in patients with ankylosing spondylitis (AS), while controlling for demographic and medical variables.
Patients with AS (n = 294) meeting modified New York criteria completed psychological measures evaluating depression, resilience, active and passive coping, internality, and helplessness. Demographic, clinical, and radiologic data were also collected. Univariate and multivariate analyses were completed to determine the strength of the correlation of psychological variables with disease activity, as measured by the Bath AS Disease Activity Index (BASDAI).
In the multivariate regression analysis, the psychological variables contributed significantly to the variance in BASDAI scores, adding an additional 33% to the overall R-square beyond that accounted for by demographic and medical variables (combined R-square 18%). Specifically, arthritis helplessness and depression accounted for the most significant portion of the variance in BASDAI scores in the final model.
Arthritis helplessness and depression accounted for significant variability in self-reported disease activity beyond clinical and demographic variables in patients with AS. These findings have important clinical implications in the treatment and monitoring of disease activity in AS, and suggest potential avenues of intervention.
在控制人口统计学和医学变量的情况下，研究心理变量在强直性脊柱炎（AS）患者自我报告的疾病活动中的作用。
符合改良纽约标准的 AS 患者（n=294）完成了评估抑郁、韧性、主动和被动应对、内在性和无助感的心理测量。还收集了人口统计学、临床和影像学数据。进行了单变量和多变量分析，以确定心理变量与疾病活动（通过 Bath AS 疾病活动指数（BASDAI）测量）的相关性强度。
在多变量回归分析中，心理变量对 BASDAI 评分的方差有显著贡献，除了人口统计学和医学变量（综合 R 平方 18%）解释的部分外，还增加了 33%。具体来说，关节炎无助感和抑郁在最终模型中对 BASDAI 评分的方差有最大的影响。
关节炎无助感和抑郁在 AS 患者的自我报告的疾病活动中，除了临床和人口统计学变量外，还解释了显著的可变性。这些发现对 AS 疾病活动的治疗和监测具有重要的临床意义，并提示了潜在的干预途径。
