Depression and Fatigue in Patients with Ankylosing Spondylitis

Abstract

Background/Purpose:

Ankylosing spondylitis (AS) is a chronic inflammatory disease that leads to bony ankyloses. The disease occurs in early adulthood, a critical stage in life, causing physical and mental problems. There are many researches on the degrees of ankyloses and activity of the disease, but studies correlating AS with psychological effects—such as depression and fatigue—are rarer. Therefore, we sought to identify depression status in patients with AS and to find correlations among depression, fatigue, and disease activity.

Methods: The subjects of the study were 300 patients with AS, whose data were collected in the hospital from March 2017 to April 2017. All subjects agreed to participate in the research. The data were collected based on the self-reported survey that inquires general features (sex, age, and disease period) and the level of depression measured by CES-D. Based on the CES-D score, the patients were grouped depending on depression level (0-15: normal, 16-21: moderate, 22 : severe). Depression levels were compared to the disease activity measured by BASDAI, BASFI, ESR, CRP and fatigue level, measured by FACIT-F. The collected data were statistically analyzed utilizing SPSS statistics 24.0.

Results: 82.7 % of the patients were male, and average age and disease duration were 37.9 years old and 7.21 years. 21 percent of the patients reported smoking, and 55 % drinking. 3.3 % were diagnosed with depression, with a BASDAI of 3.35 and BASFI of 1.72. ESR and CRP were 19.02 mm/hr and 1.25 mg/dl each. The average of CES-D, or level of depression, was 11.12, which is normal, but 22.1 % of the patients had a moderate depression level. The degree of depression correlated with BASDAI, BASFI, and FACIT-F, but it was unrelated with disease duration. The fatigue level was 15.5, which is normal, and was less than the degree of depression. Fatigue showed a correlation with depression and disease activity. Depression was shown to be correlated with diseases activity (BASDAI, BASFI), but fatigue was not.

Conclusion:

22 % of the patients with AS showed a moderate level of depression, which need intensive treatment. Depression levels correlated with disease activity, but it was unrelated with disease period. It seems that the aftereffects of AS continue after the onset of the disease. This study may contribute to reducing disease activity and improving AS patients’ quality of life by regulating depression and fatigue.