Incidence of Anxiety and Depression after Achievement of Inactive/low Disease Activity in Axial/Spondyloarthropathy

Abstract

Abstract Objectives Axial spondyloarthropathy (axSpA) is a common rheumatic disease in young people and has important physiosocial implications. The purpose of this study is to examine the frequency of anxiety and depression in axSpA patients and to check whether achieving inactive/low disease activity or taking TNF inhibitors has a positive effect on anxiety/depression and quality of life (QOL). Methods 149 axSpA patients were examined cross-sectionally over a period of two years. Baseline characteristics were recorded. Disease activity is measured using the ASDAS-CRP index. The patients were evaluated in 2 groups according to their disease activity, as inactive-low disease activity or moderate-high disease activity. The treatments they received were analysed into two groups as NSAIDs and TNF inhibitors. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Quality of life was measured with the EuroQOL (EQ5D). Results 33.6% of all axSpA patients were diagnosed with probable anxiety disorder and 47% with probable depression. These rates were similar in inactive-low disease activity patients, with 38% for anxiety and 32% for depression. While the incidence of anxiety and depression did not change between patients with inactive- low disease activity and moderate-high disease activity (for anxiety p=0.173 and for depression p=0.375), there was also no difference between patients receiving TNF inhibitor treatment and NSAIDs (p=0.149 and p=0.235). Radiographic form of axSpA was predictive of probable anxiety and depression. Peripheral arthritis is also predictive of probable depression. Conclusion Although axSpA patients had inactive-low disease activity and received TNF inhibitors, there was no significant reduction in the incidence of anxiety and depression. In addition to controlling disease activity and inflammation, regular psychosocial assessment should be part of the management of axSpA patients.