The Impact of Depression on Disease Activity and Quality of Life Indices in Patients with Ankylosing Spondylitis
Abstract
Objective:
The aim of this study is to evaluate the frequency of depression in patients
with AS and the effects of depression on disease activity and the quality of
life indices.
Materials and methods: One hundred forty-four patients diagnosed
as AS according to modified New York criteria were included to the study. Beck
Depression Index (BDI) was used to assess depression level and Beck Anxiety
Index (BAI) was used to evaluate anxiety. The disease activity was assessed by
the Bath AS Disease Activity Index (BASDAI), spinal mobility by the Bath AS
metrology index (BASMI) and the functional status by the Bath AS functional
index (BASFI). A number of different indices were used to assess quality of
life and the relationships between depression and these parameters were analyzed.
Results: Of the
144 AS patients included to the study, 71.5% were male and the mean age was
39.07 (10.8). Depression according to BDI was detected in 27.5% of patients and
middle and high-level anxiety according to BAI were in 33.6% of patients. Patients
with depression according to BDI had significantly higher disease activity
measured by BASDAI and BASFI (p = 0.008, p = 0.002, respectively). Patients
with depression had a negative impact on all quality of life indices. Patients
with depression had also higher frequency of anxiety. The frequency of
depression increased 1.55 fold (95% confidence interval 1.043-2.31, p <0.05)
in patients with BASDAI ≥ 4. The evaluation of
psychiatric status may be considered as a component of clinical evaluation in patients
with AS. The therapeutic methods that aim to improve the deterioration of
quality of life may also contribute to patients’ compliance to AS treatment.
References
- 1.Braun J, Sieper J. Ankylosing spondylitis. Lancet 2007;369:1379–1390.
- 2.Will R, Edmunds L, Elswood J, Calin A. Is there sexual inequality in ankylosing spondylitis? A study of 498 women and 1202 men. J Rheumatol 1990;17:1649-52.
- 3.Dalyan M, Guner A, Tuncer S, Bilgic A, Arasil T . Disability in ankylosing spondylitis. Disabil Rehabil 1999; 21:74-79.
- 4.Ozgül A, Peker F, Taşkaynatan M. A. Ankilozan spondilitte hastalığın yaşam kalitesi ve yaşam alanlarına etkisi. Romatizma 2003; 18: 82-91.
- 5. Barlow JH, Macey SJ, Struthers GR. Gender, depression, and ankylosing spondylitis. Arthritis Care Res 1993;6:45–51.
- 6.Hyphantis T, Kotsis K, Tsifetaki N, Creed F, Drosos AA, Carvalho AF, et al. The relationship between depressive symptoms, illnessperceptions and quality of life in ankylosing spondylitis in comparison to rheumatoid arthritis. Clin Rheumatol 2013;32:635-44.
- 7.Hakkou J, RostomS, AissaouiN, BerradaKR, Abouqal R, Bahiri R, et al.Psychological status in Moroccan patients with ankylosing spondylitisand its relationships with disease parameters and quality of life. J Clin Rheumatol 2011;17:424-8.
- 8.Martindale J, Smith J, Sutton CJ, Grennan D, Goodacre L, Goodacre JA. Disease and psychological status in ankylosing spondylitis. Rheumatology 2006;45:1288–1293.
- 9.Eren I, Sahin M, Cure E, Inanlı IC, Tunc SE, Kucuk A. Interaction between psychiatric symptoms and disability and quality of life in ankylosing spondylitis patients. Arch Neuropsychiatry 2007;44:1-9.
- 10.Van der Linden S, Valkenburg H, Cats A. Evaluation of diagnostic criteria for anklosing spondylitis: A proposal for modification of the New York criteria. Arthritis Rheum 1984; 27: 361-368.
- 11. Hisli N. Beck Depresyon envanterinin geçerliliği üzerine bir çalışma. Psikoloji Dergisi 1988; 22:118-126.
- 12. Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: Psychometric properties. J Cogn Psychother 1998;12: 163-172.
- 13. Jones SD, Steiner A, Garrett SL, Calin A. The Bath Ankylosing Spondylitis Patient Global Score (BAS-G). Br J Rheumatol 1996;35:66-71.
- 14. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: The Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 1994; 21: 2286-2291.
- 15. Jenkinson TR, Mallorie PA, Whitelock HC, Kennedy LG, Garrett SL, Calin A. Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS Metrology Index. J Rheumatol 1994; 21: 1694-1698.
- 16. Doward LC, Spoorenberg A, Cook SA, Whalley D, Helliwell PS, Kay LJ, et al. Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis. Ann Rheum Dis2003; 62: 20-26.
- 17. Johnsen LG, Hellum C, Nygaard OP, Storheim K, Brox JI, Rossvoll I, et al. Comparison of the SF6D, the EQ5D, and the owwestry disability index in patients with chronic low back pain and degenerative disc disease. BMC Musculoskelet Disord. 2013;14:148.
- 18. Farivar SS, Cunningham WE, Hays RD. Correlated physical and mental health summary scores for the SF-36 and SF-12 Health Survey, V.1. Health Qual Life Outcomes. 2007; 5: 54.
- 19. Rohde G, Berg KH, Prøven A, Haugeberg G. The relationship between demographic- and disease-related variables and health-related quality of life in patients with axial spondyloarthritis. BMC Musculoskelet Disord 2017;18:328.
- 20. Kaan U, Ferda O. Evaluation of clinical activity andfunctional impairment in smokers with ankylosing spondylitis. Rheumatol Int 2005; 25: 3573-60.
- 21. Ersözlü-Bozkırlı ED, Keşkek SO, Bozkırlı E, Yücel AE. The effect of infliximab on depressive symptoms in patients with ankylosing spondylitis. Acta Reumatol Port 2015;40:262-267.
- 22. Raison CL, Capuron L, Miller AH. Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends Immunol 2006;27:24–31.
Ankilozan Spondiliti Olan Hastalarda Depresyonun, Hastalık Aktivitesi ve Yaşam Kalite Ölçekleri Üzerine Etkileri
Abstract
Amaç: Bu çalışmanın amacı, AS
hastalarında depresyonun sıklığını ve depresyonun hastalık aktivite ve yaşam
kalite ölçekleri üzerine olan etkilerini değerlendirmektir.
Gereç ve yöntemler: Çalışmamıza modifiye New York
Kriterlerine göre AS tanısı almış 144 hasta dahil edildi. Depresyon düzeyi
değerlendirilmesi için Beck Depresyon Ölçeği (BDÖ), anksiyete değerlendirmesi
için ise Beck Anksiyete Ölçeği (BAÖ) formları kullanıldı. AS hastalarında hastalık aktivitesi Bath AS Hastalık Aktivite İndeksi
(BASDAİ) ile, spinal mobilite Bath AS metroloji indeksi (BASMİ) ile ve
fonksiyonel durum ise Bath AS fonksiyonel indeksi (BASFİ) ile değerlendirildi. Yaşam
kalitesini değerlendirmek için bir çok farklı indeks kullanılarak depresyon ile
bu parametreler arasındaki ilişkiler analiz edildi.
Sonuç: Çalışmaya dahil edilen 144 AS
hastasının %71.5’u erkekti ve ortalama yaşları ise 39.07 (10.8) olarak
saptandı.
Hastaların %27.5’inde BDÖ’ye göre depresyon ve %33.6’sında BAÖ’e göre orta
ve yüksek düzeyde anksiyete tespit edildi.
BDÖ’ye göre depresyonda olan hastaların BASDAİ ve BASFİ ile ölçülen
hastalık aktivitesi yüksek olarak bulundu (sırasıyla, p=0.008, p=0.002). Depresyonu
olan hastalarda tüm ya yaşam kalite ölçeklerinde olumsuz yönde bir etkilenme
vardı. Depresyonu olan hastalarda anksiyete sıklığı da yüksekti. BASDAİ ≥
4 olan hastalarda depresyon sıklığının
1.55 kat (%95 güvenlik aralığında 1.043-2.31, p<0.05) arttığı gözlemlendi. AS hastalarında
psikiyatrik durum değerlendirmesi klinik değerlendirmenin bir parçası olarak
düşünülebilir. Depresyonun da katkıda bulunduğu yaşam kalitesindeki bozulmanın
düzeltilmesini hedefleyen tedavi yöntemleri, hastaların AS tedavisine uyumuna
da katkı sağlayabilir.
References
- 1.Braun J, Sieper J. Ankylosing spondylitis. Lancet 2007;369:1379–1390.
- 2.Will R, Edmunds L, Elswood J, Calin A. Is there sexual inequality in ankylosing spondylitis? A study of 498 women and 1202 men. J Rheumatol 1990;17:1649-52.
- 3.Dalyan M, Guner A, Tuncer S, Bilgic A, Arasil T . Disability in ankylosing spondylitis. Disabil Rehabil 1999; 21:74-79.
- 4.Ozgül A, Peker F, Taşkaynatan M. A. Ankilozan spondilitte hastalığın yaşam kalitesi ve yaşam alanlarına etkisi. Romatizma 2003; 18: 82-91.
- 5. Barlow JH, Macey SJ, Struthers GR. Gender, depression, and ankylosing spondylitis. Arthritis Care Res 1993;6:45–51.
- 6.Hyphantis T, Kotsis K, Tsifetaki N, Creed F, Drosos AA, Carvalho AF, et al. The relationship between depressive symptoms, illnessperceptions and quality of life in ankylosing spondylitis in comparison to rheumatoid arthritis. Clin Rheumatol 2013;32:635-44.
- 7.Hakkou J, RostomS, AissaouiN, BerradaKR, Abouqal R, Bahiri R, et al.Psychological status in Moroccan patients with ankylosing spondylitisand its relationships with disease parameters and quality of life. J Clin Rheumatol 2011;17:424-8.
- 8.Martindale J, Smith J, Sutton CJ, Grennan D, Goodacre L, Goodacre JA. Disease and psychological status in ankylosing spondylitis. Rheumatology 2006;45:1288–1293.
- 9.Eren I, Sahin M, Cure E, Inanlı IC, Tunc SE, Kucuk A. Interaction between psychiatric symptoms and disability and quality of life in ankylosing spondylitis patients. Arch Neuropsychiatry 2007;44:1-9.
- 10.Van der Linden S, Valkenburg H, Cats A. Evaluation of diagnostic criteria for anklosing spondylitis: A proposal for modification of the New York criteria. Arthritis Rheum 1984; 27: 361-368.
- 11. Hisli N. Beck Depresyon envanterinin geçerliliği üzerine bir çalışma. Psikoloji Dergisi 1988; 22:118-126.
- 12. Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: Psychometric properties. J Cogn Psychother 1998;12: 163-172.
- 13. Jones SD, Steiner A, Garrett SL, Calin A. The Bath Ankylosing Spondylitis Patient Global Score (BAS-G). Br J Rheumatol 1996;35:66-71.
- 14. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: The Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 1994; 21: 2286-2291.
- 15. Jenkinson TR, Mallorie PA, Whitelock HC, Kennedy LG, Garrett SL, Calin A. Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS Metrology Index. J Rheumatol 1994; 21: 1694-1698.
- 16. Doward LC, Spoorenberg A, Cook SA, Whalley D, Helliwell PS, Kay LJ, et al. Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis. Ann Rheum Dis2003; 62: 20-26.
- 17. Johnsen LG, Hellum C, Nygaard OP, Storheim K, Brox JI, Rossvoll I, et al. Comparison of the SF6D, the EQ5D, and the owwestry disability index in patients with chronic low back pain and degenerative disc disease. BMC Musculoskelet Disord. 2013;14:148.
- 18. Farivar SS, Cunningham WE, Hays RD. Correlated physical and mental health summary scores for the SF-36 and SF-12 Health Survey, V.1. Health Qual Life Outcomes. 2007; 5: 54.
- 19. Rohde G, Berg KH, Prøven A, Haugeberg G. The relationship between demographic- and disease-related variables and health-related quality of life in patients with axial spondyloarthritis. BMC Musculoskelet Disord 2017;18:328.
- 20. Kaan U, Ferda O. Evaluation of clinical activity andfunctional impairment in smokers with ankylosing spondylitis. Rheumatol Int 2005; 25: 3573-60.
- 21. Ersözlü-Bozkırlı ED, Keşkek SO, Bozkırlı E, Yücel AE. The effect of infliximab on depressive symptoms in patients with ankylosing spondylitis. Acta Reumatol Port 2015;40:262-267.
- 22. Raison CL, Capuron L, Miller AH. Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends Immunol 2006;27:24–31.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | June 29, 2018 |
| Submission Date | April 29, 2018 |
| Published in Issue | Year 2018 Volume: 8 Issue: 2 |
The published articles in SMJ are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.