title: Relationship between psychological status and disease activity and quality of life in ankylosing spondylitis.
abstract: Our aim in this study was to compare the depression and anxiety risk in patients with AS and healthy controls and also to determine the relationship between disease activity, quality of life and psychological well-being. Two hundred and forty-three patients with ankylosing spondylitis (AS) and 118 age-, sex- and education-matched healthy controls were enroled into the study. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Functional Index, and Metrology Index, Health Assessment Questionnaire for Spondyloarthropathies (HAQ-S), Hospital Anxiety and Depression Scale (HADS) including depression subscale (HADS-D) and anxiety subscale (HADS-A), Ankylosing Spondylitis Quality of Life (ASQoL) Scale, duration of morning stiffness, pain-visual analogue scale (VAS), patient and physician's global assessment of disease activity (100 mm VAS) were used to assess clinical and psychological status. Patients had similar HADS-D but higher HADS-A than healthy controls. Patients with high risk for depression and anxiety had higher scores in BASDAI, BASFI and also poorer scores in VAS pain, patient global assessment, physician global assessment, HAQ-S and ASQoL. There was a negative correlation of HADS-D and HADS-A scores with educational level of the patients. Higher scores in HADS-D and HADS-A indicated poorer functional outcome and quality of life. Multivariate logistic regression analysis revealed that the HADS-D (OR=6.84), HAQ-S (OR=1.76), VAS pain score (OR=1.03) and ESR (OR=1.02) were independent risk factors for higher anxiety scores whereas HADS-A (OR=1.36) and ASQoL (OR=1.24) were independent risk factors for higher depression scores. The psychological status had close interaction with disease activity and quality of life in patients with AS.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, İnönü University, 44315, Malatya, Turkey. ozlemb@inonu.edu.tr
authors.forename: Ozlem
authors.initials: O
authors.lastname: Baysal
authors.forename: Bekir
authors.initials: B
authors.lastname: Durmuş
authors.forename: Yüksel
authors.initials: Y
authors.lastname: Ersoy
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Altay
authors.forename: Kazım
authors.initials: K
authors.lastname: Senel
authors.forename: Kemal
authors.initials: K
authors.lastname: Nas
authors.forename: Mahir
authors.initials: M
authors.lastname: Uğur
authors.forename: Arzu
authors.initials: A
authors.lastname: Kaya
authors.forename: Ali
authors.initials: A
authors.lastname: Gür
authors.forename: Akın
authors.initials: A
authors.lastname: Erdal
authors.forename: Ozge
authors.initials: O
authors.lastname: Ardıçoğlu
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Tekeoğlu
authors.forename: Remzi
authors.initials: R
authors.lastname: Cevik
authors.forename: Kadir
authors.initials: K
authors.lastname: Yıldırım
authors.forename: Ayhan
authors.initials: A
authors.lastname: Kamanlı
authors.forename: Ayşegül Jale
authors.initials: AJ
authors.lastname: Saraç
authors.forename: Saliha
authors.initials: S
authors.lastname: Karatay
authors.forename: Salih
authors.initials: S
authors.lastname: Ozgocmen
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D016059:Range of Motion, Articular; D012307:Risk Factors; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D013167:Spondylitis, Ankylosing / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D014421:Turkey / Q000453:epidemiology