Depressive Symptoms Common Among Patients With axSpA and PsA

Depressive symptoms were prevalent among nearly 30% of patients with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA), according to study results published in Arthritis Research & Therapy.

Investigators assessed the prevalence of depressive symptoms among patients with axSpA or PsA and aimed to determined factors associated with moderate or severe depressive symptoms.

Data were taken from the Rabbit-SpA observational, longitudinal cohort study, conducted by the German Rheumatism Research Center. Patients with a diagnosis of axSpA or PsA who had a valid World Health Organization-5 Well-Being Index (WHO-5) score at baseline were included in the analysis.

Depressive symptoms were measured via WHO-5 percentage scores ranging from 0 to 100. Scores were separated into 4 categories: severe depressive symptoms (scores <13), moderate depressive symptoms (scores from 13-28), mild depressive symptoms (scores from 29-50), and good well-being with no depressive symptoms (scores >50).

A total of 2470 patients (1245 with axSpA and 1225 with PsA) were included in the analysis. Patients with PsA vs axSpA were more likely to be women and of more advanced age. Values for WHO-5 scores were similar among patients with PsA and axSpA, with 8.2% and 8.2% reporting severe depressive symptoms and 20.9% and 21.5% reporting moderate depressive symptoms, respectively.

Patients with axSpA and moderate or severe depressive symptoms had a slightly shorter disease duration, reported higher scores for all measures of disease activity, more comorbidities, greater levels of functional impairment, and reported worse fatigue and pain than patients with mild or no depressive symptoms.

Patients with PsA and moderate or severe depressive symptoms were more likely to have obesity and take analgesics, with this effect being more pronounced than among the axSpA group. Compared with the axSpA group, patients with moderate or severe depressive symptoms had longer disease duration.

Similar to the axSpA group, patients with PsA and moderate or severe depressive symptoms reported worse disease activity, increased functional impairment, and worse levels of fatigue, pain, and sleep disturbances compared against patients with mild or no depressive symptoms.

Factors associated with the presence of depressive symptoms among patients with axSpA included increased disease activity (odds ratio [OR], 1.27; 95% CI, 1.04-1.56), greater functional impairment (OR, 1.25; 95% CI, 1.15-1.35), and fatigue (OR, 1.44; 95% CI, 1.33-1.56).

Similarly, factors associated with the presence of depressive symptoms among patients with PsA included greater functional impairment (OR, 1.08; 95% CI, 1.06-1.12) and fatigue (OR, 1.56; 95% CI, 1.44-1.69).

Among patients with both axSpA and PsA, those who participated in sport for at least 1 hour/week were less likely experience depressive symptoms (ORs, 0.73 and 0.61, respectively).

This study was limited by its cross-sectional design and use of the WHO-5 index, which is not a diagnostic instrument for depression.

“We conclude that mental health needs to be taken into account when assessing a patient’s situation in a more holistic way. A multidisciplinary treatment approach including psychotherapeutic interventions may help to optimize the management of disease in axSpA and PsA patients,” the study authors stated.

This article originally appeared on Rheumatology Advisor