Psychological status and patient-assessed health instruments in ankylosing spondylitis.
BACKGROUND
Determination of the relationships between disease and psychological status in ankylosing spondylitis (AS) is needed for clinical assessment and management, as well as selection and monitoring of AS patients for biological therapy.


OBJECTIVE
The study aimed to describe associations between self-reported health status and psychological factors in AS patients and to compare the Symptom Checklist 90-Revised (SCL-90-R) profiles of the AS patients and the control subjects.


METHODS
Disease status was determined through the Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), and the Bath AS Metrology Index (BASMI). Psychological status was measured using the SCL-90-R.


RESULTS
BASDAI and BASFI scores correlated with somatization, anxiety, obsessive-compulsive, depression, and hostility subscales of SCL-90-R (P ≤ 0.05). BASFI scores were significantly correlated with interpersonal sensitivity and phobic anxiety subscales of SCL-90-R (P < 0.05), whereas no correlation was observed between BASDAI and interpersonal sensitivity and phobic anxiety subscales. BASMI scores were significantly correlated with somatization and interpersonal sensitivity subscales (P < 0.05). After age and sex adjustments, a statistically significant difference was determined between the somatization scores of the AS patients and control subjects (P = 0.005).


CONCLUSIONS
AS is a chronic disease, which causes deformities and workforce decline. This, in turn, might lead to psychological distress. There is a need to assess the mood of patients with AS. Completion of self-report assessment tools are potentially confounded by reporting biases that result from psychological factors. Some patients may overreport symptoms or disability because of a tendency to somatize. Thus, during interpretation of these tools, psychological status should be taken into account especially deciding the treatment regimen including biologic therapies.
Ortancil
Ozgur
O
Department of Physical Medicine and Rehabilitation, Zonguldak Karaelmas University Faculty of Medicine, Zonguldak, Turkey. ozgurortancil@yahoo.com
Konuk
Numan
N
May
Hatice
H
Sanli
Aslan
A
Ozturk
Devrim
D
Ankarali
Handan
H
D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D059026:Diagnostic Self Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011581:Psychological Tests; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000523:psychology*