Anxiety and depression correlate with disease and quality-of-life parameters in Chinese patients with ankylosing spondylitis

Figures & data

Table 1 Demographics, psychological and disease characteristics in patients with AS and controls

Variables	AS (n=103)	Controls (n=121)	P-value
Malea	78 (75.7%)	73 (60.3%)	0.62
Age, yearsb	32.9±10.7	37.0±12.5	0.33
SAS (≥50)a	19 (18.4%)	8 (6.6%)	<0.01
SDS (≥53)a	38 (36.9%)	16 (13.2%)	<0.01
BASDAIb	2.9±2.4
BASFIb	0.9±1.5
BASMIb	2.4±1.8
HAQb	2.8±2.2
VAS painb	2.2±4.1
Abnormal ESRa	24 (23.3%)
(≥15 mm/h for men, ≥20 mm/h for women)
Abnormal CRP (≥8 mg/L)a	41 (39.8%)

Notes:

a Number (percentage), analyzed using the chi-square test;

b Mean (SD), analyzed using the Student’s t-test.

Abbreviations: AS, ankylosing spondylitis; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; BASFI, Bath Ankylosing Spondylitis Functional Index; BASMI, Bath Ankylosing Spondylitis Metrology Index; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; h, hour; HAQ, Health Assessment Questionnaire for Spondyloarthropathies; SAS, revised Self-Rating Anxiety Scale; SD, standard deviation; SDS, revised Self-Rating Depression Scale; VAS, visual analog scale.

Table 2 Pearson’s correlation among psychological scores, disease parameters, and QoL in patients with AS

Variables	SAS		SDS
	R	P-value	R	P-value
BASDAI	0.48	<0.01	0.43	<0.01
BASFI	0.21	0.13	0.18	0.20
BASMI	0.27	0.06	0.15	0.32
VAS pain	0.60	<0.01	0.51	<0.01
HAQ	0.36	<0.01	0.23	0.10
ESR	−0.04	0.80	0.13	0.37
CRP	0.15	0.29	0.18	0.21
SF-36 domains
PCS	−0.46	<0.01	−0.48	<0.01
MCS	−0.39	<0.01	−0.56	<0.01
Physical functioning	−0.37	<0.01	−0.42	<0.01
Role limitations due to physical problems	−0.39	<0.01	−0.48	<0.01
Body pain	−0.32	<0.01	−0.36	<0.01
General health perception	−0.47	<0.01	−0.29	0.03
Vitality	−0.45	<0.01	−0.52	<0.01
Social functioning	−0.15	0.29	−0.39	<0.01
Role limitations due to emotional problems	−0.40	<0.01	−0.48	<0.01
Mental health	−0.31	0.02	−0.39	<0.01

Abbreviations: AS, ankylosing spondylitis; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; BASFI, Bath Ankylosing Spondylitis Functional Index; BASMI, Bath Ankylosing Spondylitis Metrology Index; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; HAQ, Health Assessment Questionnaire for Spondyloarthropathies; MCS, mental components summary; PCS, physical components summary; QoL, quality of life; SAS, revised Self-Rating Anxiety Scale; SDS, revised Self-Rating Depression Scale; SF-36, short form 36; VAS, visual analog scale.

Table 3 Disease status and QoL in the anxious and depressed subgroups

Variables	SAS			SDS
	<50	≥50	P-value	<53	≥53	P-value
BASDAI	2.34±1.89	5.32±2.97	0.0001	1.89±1.70	3.53±2.53	0.01
BASFI	0.88±1.46	1.09±1.52	0.58	0.36±0.89	1.27±1.65	0.02
BASMI	2.37±1.80	2.67±1.79	0.51	1.95±1.77	2.55±1.96	0.06
VAS pain	2.37±2.02	4.4±2.05	0.006	1.95±1.80	3.24±2.24	0.03
HAQ	1.77±3.84	4±5.12	0.13	1.14±3.38	2.85±4.49	0.14
ESR (mm/h)	17.4±20.2	20.1±18.7	0.41	16.3±15.1	19.7±17.6	0.45
CRP (mg/L)	12.3±9.7	15±9.4	0.22	12.3±8.3	16.4±9.1	0.07
SF-36 domains
PCS	2.71±0.75	2.49±0.63	0.24	3.03±0.69	2.39±0.67	0.001
MCS	2.42±0.67	2.19±0.37	0.18	2.78±0.50	2.10±0.67	0.0002
Physical functioning	0.80±0.18	0.71±0.23	0.14	0.85±0.16	0.75±0.20	0.05
Role limitations due to physical problems	0.62±0.41	0.45±0.37	0.23	0.83±0.33	0.43±0.37	0.0002
Body pain	0.72±0.19	0.69±0.12	0.51	0.75±0.20	0.69±0.16	0.23
General health perception	0.57±0.17	0.49±0.12	0.15	0.60±0.20	0.52±0.13	0.11
Vitality	0.71±0.75	0.65±0.08	0.24	0.79±0.11	0.64±0.14	0.0001
Social functioning	0.32±0.17	0.29±0.18	0.45	0.35±0.19	0.29±0.16	0.19
Role limitations due to emotional problems	0.70±0.37	0.53±0.45	0.23	0.87±0.25	0.54±0.40	0.001
Mental health	0.70±0.15	0.63±0.16	0.21	0.77±0.11	0.64±0.15	0.002

Note: Results are presented as mean ± SD and were analyzed using the Student’s t-test.

Abbreviations: BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; BASFI, Bath Ankylosing Spondylitis Functional Index; BASMI, Bath Ankylosing Spondylitis Metrology Index; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; HAQ, Health Assessment Questionnaire for Spondyloarthropathies; MCS, mental components summary; QoL, quality of life; SAS, revised Self-Rating Anxiety Scale; SDS, revised Self-Rating Depression Scale; SF-36, short form 36; SD, standard deviation; PCS, physical components summary; VAS, visual analog scale.

Table 4 Stepwise regression analyses of medical and psychological variables and their relationship with anxiety/depression in patients with AS

	Variables	Coefficient	95% CI	P-value
Anxiety	GH	−14.28	−25.99, −2.58	0.01
	VAS pain	2.65	1.51, 3.78	<0.001
	BP	13.80	0.47, 27.13	0.04
Depression	VAS pain	−27.32	−48.10, −6.54	0.01
	VT	2.28	0.84, 3.72	0.003

Abbreviations: AS, ankylosing spondylitis; BP, body pain; CI, confidence interval; GH, general health perception; VAS, visual analog scale; VT, energy/vitality.