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

OBJECTIVE

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

METHOD

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.

RESULTS

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.

CONCLUSION

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.