强直性脊柱炎患者抑郁、焦虑和压力的相关因素。
Correlates of depression, anxiety, and stress among patients with ankylosing spondylitis.
作者信息
Yang Kun, Gong Yifan, Geng Zhaoyang, Xu Xan, Yan Shiyan, Zhang Haoran, Jiang Quan, Liu Hongxiao
机构信息
Guang'anmen Hospital of Chinese Academy of Traditional Chinese Medicine, Beijing, China.
Beijing University of Chinese Medicine, Beijing, China.
出版信息
Adv Rheumatol. 2025 Mar 14;65(1):14. doi: 10.1186/s42358-025-00439-6.
BACKGROUND
The recurrent nature and prolonged course of ankylosing spondylitis (AS) impose substantial psychological disorders on patients. The aim of this study was to assess psychological disorders and analyze the overall risk of psychological disorders as well as the factors associated with depression, anxiety, and stress in ankylosing spondylitis.
METHODS
Patients diagnosed with AS were selected from the China Rheumatoid Arthritis Registry of Patients with Chinese Medicine (CERTAIN) database for data analysis. General demographic characteristics and disease-related features of the patients were collected. The study analyzed clinical differences between patients with and without psychological disorders. Specific clinical characteristics of depression, anxiety, and stress were statistically analyzed. Clinical factors associated with overall psychological status and specific psychological disorders (depression, anxiety and stress) were analyzed by multivariate logistic regression.
RESULTS
In our study cohort, 26.72% of AS patients were identified with psychological disorders, with 17.5% experiencing depression, 21.1% suffering from anxiety, and 7.9% reporting stress. We also observed significant overlaps among depression, anxiety, and stress in AS patients, with 53.47% experiencing multiple psychological disorders. Disease activity, health index, fatigue levels, and PGA were identified as significant factors associated with psychological disorders. Age, health index, fatigue levels, and PGA were the main influencing factors for depression; disease activity and PGA for anxiety; and disease activity, ASAS-HI, and fatigue for stress.
CONCLUSIONS
The study reveals a significant prevalence of psychological disorders among individuals with AS, which correlates closely with disease activity, health index, fatigue levels, and PGA. These findings highlight the imperative for assessment of psychological conditions into the comprehensive management approach for AS patients.
背景
强直性脊柱炎（AS）的复发性和病程迁延给患者带来了严重的心理障碍。本研究旨在评估心理障碍，分析心理障碍的总体风险以及与强直性脊柱炎患者抑郁、焦虑和压力相关的因素。
方法
从中国类风湿关节炎中医患者注册数据库（CERTAIN）中选取诊断为AS的患者进行数据分析。收集患者的一般人口统计学特征和疾病相关特征。本研究分析了有无心理障碍患者之间的临床差异。对抑郁、焦虑和压力的具体临床特征进行了统计分析。通过多因素逻辑回归分析与总体心理状态和特定心理障碍（抑郁、焦虑和压力）相关的临床因素。
结果
在我们的研究队列中，26.72%的AS患者被确定存在心理障碍，其中17.5%患有抑郁症，21.1%患有焦虑症，7.9%报告有压力。我们还观察到AS患者的抑郁、焦虑和压力之间存在显著重叠，53.47%的患者患有多种心理障碍。疾病活动度、健康指数、疲劳水平和医师整体评估（PGA）被确定为与心理障碍相关的重要因素。年龄、健康指数、疲劳水平和PGA是抑郁的主要影响因素；疾病活动度和PGA是焦虑的主要影响因素；疾病活动度、强直性脊柱炎病情活动度健康指数（ASAS-HI）和疲劳是压力的主要影响因素。
结论
该研究揭示了AS患者中心理障碍的患病率较高，这与疾病活动度、健康指数、疲劳水平和PGA密切相关。这些发现凸显了在AS患者的综合管理方法中评估心理状况的必要性。
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