Queiro Rubén, Alonso Sara, Morante Isla, Alperi Mercedes
Rheumatology Division, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.
ISPA Translational Immunology Division, 33011 Oviedo, Spain.
J Clin Med. 2022 Oct 16;11(20):6094. doi: 10.3390/jcm11206094.
Background: Psychosocial health is a key driver of quality of life (QoL) in axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA), but it is often overlooked in clinical practice. We aimed to analyze this aspect of QoL by using the Assessment of SpA International Society−Health Index (ASAS HI) in both SpA phenotypes. Patients and methods: One hundred and eleven patients with axSpA and 90 with PsA were consecutively recruited from two rheumatology centers. In both populations, the categories of stress handling (ASAS HI items #11 and 17) and emotional functions (ASAS HI item #13) were analyzed based on the International Classification of Functioning, Disability, and Health (ICF). A multivariate regression model was used to analyze the explanatory factors associated with positive responses to these items. Results: Thirty-four of the 90 PsA patients (37.8%) and 37/111 of the patients (33.3%) with axSpA reported a positive response to at least one of the stress-handling items. Compared to the patients with PsA, patients with axSpA were less likely to report stress-handling issues (OR 0.48, p < 0.05). Thirty-one of the 90 PsA patients (34.4%) and 44/111 of the patients (39.6%) with axSpA reported positive responses to item #13. In both groups of SpA patients, disease activity and severity (OR 6.6, p < 0.001) were independently associated with alterations in psychosocial health. Compared with those in the axSpA group, the psychosocial health items were better correlated with each other and with the ASAS HI sum score in the PsA group. Conclusions: Psychosocial health is frequently altered in SpA. Both disease activity and severity are associated with this issue. However, psychosocial factors seem to have a greater impact on QoL in PsA than in axSpA.
心理社会健康是轴性脊柱关节炎（axSpA）和银屑病关节炎（PsA）患者生活质量（QoL）的关键驱动因素，但在临床实践中常被忽视。我们旨在通过使用脊柱关节炎国际协会健康指数（ASAS HI）来分析这两种脊柱关节炎（SpA）表型患者生活质量的这一方面。
从两个风湿病中心连续招募了111例axSpA患者和90例PsA患者。在这两个人群中，基于国际功能、残疾和健康分类（ICF）对压力应对类别（ASAS HI项目#11和#17）和情绪功能（ASAS HI项目#13）进行了分析。使用多元回归模型分析与这些项目的积极反应相关的解释因素。
90例PsA患者中有34例（37.8%），111例axSpA患者中有37例（33.3%）报告对至少一项压力应对项目有积极反应。与PsA患者相比，axSpA患者报告压力应对问题的可能性较小（比值比0.48，p<0.05）。90例PsA患者中有31例（34.4%），111例axSpA患者中有44例（39.6%）报告对项目#13有积极反应。在两组SpA患者中，疾病活动度和严重程度（比值比6.6，p<0.001）与心理社会健康改变独立相关。与axSpA组相比，PsA组的心理社会健康项目之间以及与ASAS HI总分的相关性更好。
SpA患者的心理社会健康经常发生改变。疾病活动度和严重程度均与这一问题相关。然而，心理社会因素似乎对PsA患者生活质量的影响比对axSpA患者更大。
