Department of Rheumatology, El Ayachi University Hospital, Sale, Morocco.
J Clin Rheumatol. 2011 Dec;17(8):424-8. doi: 10.1097/RHU.0b013e31823a498e.
The evaluation of emotional status is an important parameter in management of rheumatic diseases. There are few studies evaluating the psychological status in ankylosing spondylitis (AS) and its relationships with disease parameters and quality of life.
In this study, we evaluated the psychological status in Moroccan patients with AS and its relationships with the activity of the disease, the functional status, and the quality of life.
One hundred ten patients were included in this cross-sectional study according to the modified New York criteria for AS. Psychological status was assessed by the Hospital Anxiety and Depression Scale (HADS) including the depression and anxiety subscales. The quality of life was evaluated by the Short Form 36.
Depression was found in 55.5% and anxiety in 60% among our patients. The HADS depression and anxiety subscales were significantly correlated with clinical parameters and with worsening in all domains of the Short Form 36.Multivariate logistic regression analysis revealed that role limitations due to emotional problems, vitality, and general health perception were independent risk factors of anxiety. The Bath Ankylosing Spondylitis Functional Index, vitality, and role limitations due to emotional problems were the independent factors that influenced the risk of depression.
This study suggests that depression and anxiety are frequent in AS. Impaired quality of life and functional disability seemed to be independent risk factors of psychological disorders. Therefore, assessment and management of patients with AS should take into account the evaluation and management of their psychological disorders and improvement of their functional disability.
评估情绪状态是风湿性疾病管理的一个重要参数。评估强直性脊柱炎（AS）患者心理状态及其与疾病参数和生活质量之间关系的研究较少。
本研究评估了摩洛哥 AS 患者的心理状态及其与疾病活动度、功能状态和生活质量的关系。
根据改良的纽约 AS 标准，110 例患者纳入本横断面研究。采用医院焦虑抑郁量表（HADS）评估心理状态，包括抑郁和焦虑两个亚量表。采用简明 36 健康状况量表（SF-36）评估生活质量。
我们的患者中，55.5%存在抑郁，60%存在焦虑。HADS 抑郁和焦虑亚量表与临床参数显著相关，与 SF-36 所有领域的恶化均显著相关。多变量逻辑回归分析显示，情绪问题导致的角色受限、活力和一般健康感知是焦虑的独立危险因素。Bath 强直性脊柱炎功能指数、活力和情绪问题导致的角色受限是影响抑郁风险的独立因素。
本研究表明，抑郁和焦虑在 AS 中很常见。生活质量受损和功能障碍似乎是心理障碍的独立危险因素。因此，评估和管理 AS 患者时，应考虑评估和管理其心理障碍，并改善其功能障碍。
