German Rheumatism Research Center (DRFZ Berlin), Epidemiology and Health Services Research, Berlin, Germany.
Ruhr University Bochum, Bochum, Germany.
Arthritis Res Ther. 2023 Aug 2;25(1):136. doi: 10.1186/s13075-023-03127-2.
In patients with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA), concomitant depression might have a negative impact on the course of disease and treatment outcomes. The aims of this analysis are to determine the prevalence of depressive symptoms in axSpA and PsA patients in a real-world cohort study and to identify sociodemographic and clinical associated factors for moderate or severe depressive symptoms in both diseases.
Patients from the RABBIT-SpA cohort with an axSpA or PsA diagnosis and a valid WHO-5 Well-Being Index score at baseline were included. A descriptive analysis of baseline and outcome parameters by category of depressive symptoms was performed and factors associated with the presence of depressive symptoms (moderate or severe) were examined in a logistic regression.
Two thousand four hundred seventy patients (1,245 axSpA; 1,225 PsA) were included in the analysis. In both diagnoses, the proportion of patients with moderate depressive symptoms was 8% and 21% with severe symptoms. Patients with moderate or severe depressive symptoms were less likely to engage in sports than those with no or mild depressive symptoms, had more comorbidities and higher scores for disease activity, functional limitations, fatigue, and pain and took more analgesics. In axSpA, patients with a higher disease activity, a greater functional impairment and more severe fatigue were more likely to experience depressive symptoms, while patients with more years in education and engaging in sports for at least 1 h/week were less likely to experience depressive symptoms. PsA patients with a greater functional impairment and more severe fatigue were more likely to experience depressive symptoms while those engaging in sports for at least 1 h/week were less likely to experience depressive symptoms.
We confirmed a high prevalence of depressive symptoms in both PsA and axSpA. Factors negatively associated with the presence of depressive symptoms were fatigue, not engaging in sports, and greater functional limitations. Depressive symptoms may affect the perception of disease activity / severity by patients. Thus, depressive symptoms are an important condition in axSpA and PsA that should be considered when evaluating disease activity and treatment outcomes.
在患有中轴型脊柱关节炎（axSpA）或银屑病关节炎（PsA）的患者中，并存的抑郁可能对疾病过程和治疗结局产生负面影响。本分析的目的是在真实世界队列研究中确定 axSpA 和 PsA 患者中抑郁症状的患病率，并确定这两种疾病中中重度抑郁症状的社会人口学和临床相关因素。
本研究纳入了 RABBIT-SpA 队列中具有 axSpA 或 PsA 诊断且基线时 WHO-5 健康状况指数评分有效的患者。通过抑郁症状类别对基线和结局参数进行描述性分析，并在逻辑回归中检查与抑郁症状（中重度）存在相关的因素。
本研究共纳入了 2470 名患者（1245 名 axSpA；1225 名 PsA）。在这两种诊断中，中重度抑郁症状患者的比例分别为 8%和 21%。与无或轻度抑郁症状的患者相比，有中重度抑郁症状的患者更不可能进行体育活动，有更多的合并症，疾病活动度、功能受限、疲劳和疼痛评分更高，使用更多的镇痛药。在 axSpA 中，疾病活动度较高、功能障碍更严重和疲劳更严重的患者更有可能出现抑郁症状，而受教育程度更高和每周至少进行 1 小时体育活动的患者出现抑郁症状的可能性较小。PsA 患者中，功能障碍更严重和疲劳更严重的患者更有可能出现抑郁症状，而每周至少进行 1 小时体育活动的患者出现抑郁症状的可能性较小。
我们证实了 PsA 和 axSpA 中抑郁症状的高患病率。与抑郁症状不存在相关的因素是疲劳、不参加体育活动和更大的功能障碍。抑郁症状可能会影响患者对疾病活动度/严重程度的感知。因此，抑郁症状是 axSpA 和 PsA 中的一个重要状况，在评估疾病活动度和治疗结局时应予以考虑。
