Psychological correlates of self-reported disease activity in ankylosing spondylitis.
OBJECTIVE
To investigate the role of psychological variables in self-reported disease activity in patients with ankylosing spondylitis (AS), while controlling for demographic and medical variables.


METHODS
Patients with AS (n = 294) meeting modified New York criteria completed psychological measures evaluating depression, resilience, active and passive coping, internality, and helplessness. Demographic, clinical, and radiologic data were also collected. Univariate and multivariate analyses were completed to determine the strength of the correlation of psychological variables with disease activity, as measured by the Bath AS Disease Activity Index (BASDAI).


RESULTS
In the multivariate regression analysis, the psychological variables contributed significantly to the variance in BASDAI scores, adding an additional 33% to the overall R-square beyond that accounted for by demographic and medical variables (combined R-square 18%). Specifically, arthritis helplessness and depression accounted for the most significant portion of the variance in BASDAI scores in the final model.


CONCLUSIONS
Arthritis helplessness and depression accounted for significant variability in self-reported disease activity beyond clinical and demographic variables in patients with AS. These findings have important clinical implications in the treatment and monitoring of disease activity in AS, and suggest potential avenues of intervention.
Department of Medicine, Division of Rheumatology, University of Texas Health Science Center at Houston, Houston, Texas 77030, USA.
Tamar F
TF
Brionez
Shervin
S
Assassi
John D
JD
Reveille
Charles
C
Green
Thomas
T
Learch
Laura
L
Diekman
Michael M
MM
Ward
John C
JC
Davis
Michael H
MH
Weisman
Perry
P
Nicassio
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012044:Regression Analysis; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000523:psychology*; D011795:Surveys and Questionnaires