Assessment of Quality of Life, Psychological and Functional Status and Disease Activity in Patients with Ankylosing Spondylitis and Fibromyalgia

Abstract

Objective: Anxiety and depression are psychological disorders which frequently accompany and affect the course of rheumatic diseases. Quality of life is also affected by psychological status. In this study, we aimed to assess psychological status and quality of life in patients with ankylosing spondylitis (AS) and fibromyalgia (FM) and investigate their association with functional status, disease activity and physical limitation. Method: Thirty-seven patients with AS and thirty-four patients with FM were included in this study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) were used for assessment of disease activity and physical functions respectively. The Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire was used for disease-related quality of life in AS patients. Fibromyalgia Impact Questionnaire (FIQ) was used for assessment of functional status in FM patients. Nottingham Health Profile (NHP) and the Hospital Anxiety and Depression Scale (HADS) were, respectively, used for assessment of quality of life and psychological status in groups. Results: There was no significant difference between the groups in HADS-total, HADS-depression and HADS-anxiety scores (p>0.05). However, patients with FM had significantly higher NHP-total and NHP-pain scores compared to patients with AS (p<0.05). Conclusion: There was no significant difference between the two groups in psychological distress. Higher NHP-pain scores in patients with FM might have been caused by lower pain threshold in these patients. The generalizability of our findings is also limited because of the relatively small sample size. J Clin Exp Invest 2016; 7 (1): 41-46

Keywords

• Psychological status,functional status,quality of life,ankylosing spondylitis,fibromyalgia

Kaynakça

1. 1. Wolfe F, Ross K, Anderson J, et al. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 1995;38:19-28.
2. 2. Yoshikawa GT, Heymann RE, Helfenstein MJ. A comparison of quality of life, demographic and clinical characteristics of Brazilianmen with fibromyalgia syndrome with male patients with depression. Rheumatol Int 2010;30:474-478,
3. 3. Epstein SA, Kay G, Clauw D, et al. Psychiatric disorders in patients with fibromyalgia. A multicenter investigation. Psychosomatics 1999;40:57-63.
4. 4. Ahles TA, Khan SA, Yunus MB, et al. Psychiatric status of patients with primary fibromyalgia, patients with rheumatoid arthritis, and subjects without pain: a blind comparison of DSM-III diagnoses. Am J Psychiatry 1991;148:1721- 1726
5. 5. Krag NJ, Norregaard J, Larsen JK, Danneskiold-Samsoe B. A blinded, controlled evaluation of anxiety and depressive symptoms in patients with fibromyalgia, as measured by standardized psychometric interview scales. Acta Psychiatr Scand 1994;89:370-375.
6. 6. Klippel JH, Stone JH, Crofford LJ, White PH (eds). Primer on the rheumatic diseases, 13th edn. Springer, New York, 2008.
7. 7. Martindale J, Smith J, Sutton CJ, et al. Disease and psychological status in ankylosing spondylitis. Rheumatology 2006;45:1288-1293.
8. 8. Lim HJ, Moon YI, Lee MS. Effects of home-based Daily exercise therapy on joint mobility, daily activity, pain, and depression in patients with ankylosing spondylitis. Rheumatol Int 2005;25:225-229.

9. 9. Calin A, Edmunds L, Kennedy LG. Fatigue in ankylosing spondylitis-why is it ignored? J Rheumatol 1993;20:991- 995.
10. 10. Ovayolu N, Ovayolu, Karadag G. Health-related quality of life in ankylosing spondylitis, fibromyalgia syndrome, and rheumatoid arthritis: a comparison with a selected sample of healthy ındividuals Clin Rheumatol 2011;30:655-664.
11. 11. Hyphantis T, Kotsis K, Tsifetaki N, et al. The relationship between depressive symptoms, illness perceptions and quality of life in ankylosing spondylitis in comparison to rheumatoid arthritis. Clin Rheumatol. 2013;32:635-644.
12. 12. Van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 1984;27:361-368
13. 13. Wolfe F, Smythe HA, Yunus MB et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arthritis Rheum 1990;33:160-172.
14. 14. Garrett S, Jenkinson T, Kennedy LG, et al. A new approach to defining disease status in ankylosing spondylitis: the bath ankylosing spondylitis disease activity index. J Rheumatol 1994;21:2286-2291.
15. 15. Akkoc Y, Karatepe AG, Akar S, et al. A Turkish version of the Bath Ankylosing Spondylitis Disease Activity Index: reliability and validity. Rheumatol Int 2005;25:280-284.
16. 16. Calin A, Garrett S, Whitelock H, et al. A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index .J Rheumatol 1994;21:2281-2285.
17. 17. Doward LC, Spoorenberg A, Cook SA. Development of ASQoL: a quality of life instrument specific to ankylosing spondylitis. Ann Rheum Dis 2003;62:20-26.
18. 18. Duruöz MT, Doward L, Turan Y, et al. Translation and validation of the Turkish version of the ankylosing spondylitis quality of life (ASQoL) Questionnaire. Rheumatol Int. 2013;33:2717-2722.
19. 19. Burckhardt CS, Clark SR, Bennett RM. The fibromyalgia impact questionnaire: development and validation. J Rheumatol 1991;18:728-733.
20. 20. Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the fibromyalgia impact questionnaire. Rheumatol Int 2000;20:9-12.
21. 21. Hunt SM, McKenna SP, McEwen J, et al. The Nottingham Health Profile: subjective health status and medical consultations. Soc Sci Med A 1981;15:221-229.
22. 22. Kucukdeveci AA, McKenna SP, Kutlay S, et al. The development and psychometric assessment of the Turkish version of the Nottingham health profile. Int J Rehabil Res 2000;23:31-38.
23. 23. Zigmond AS, Snaith PR. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361-370.
24. 24. Aydemir O, Guvenir T, Kuey L, Kultur S. Validity and reliability of Turkish version of hospital anxiety and depression scale. Turk Psikiyatri Dergisi 1997;8:280-287.
25. 25. Wells KB, Golding JM, Burnam MA. Psychiatric disorder in a sample of the general population with and without chronic medical conditions. Am J Psychiatry 1988;145:976-981.
26. 26. Baysal O, Durmus B, Ersoy Y, et al. Relationship between psychological status and disease activity and quality of life in ankylosing spondylitis. Rheumatol Int 2011;31:795-800.
27. 27. Ozgul A, Peker F, Taskaynatan MA, et al. Effect of ankylosing spondylitis on health-related quality of life and different aspects of social life in young patients. Clin Rheumatol 2006;25:168-174.
28. 28. Zautra AC, Fasman R, Parish BP, Davis MC. Daily fatigue in women with osteoarthritis, rheumatoid arthritis, and fibromyalgia. Pain 2007;128:128-135.
29. 29. Ofluoglu D, Berker N, Guven Z, et al. Quality of life in patients with fibromyalgia syndrome and rheumatoid arthritis. Clin Rheumatol 2005;24:490-492.
30. 30. Staud R, Spaeth M. Psychophysical and neurochemical abnormalities of pain processing in fibromyalgia CNS Spectr 2008;13:12-17. 31. Sumpton JE, Moulin DE. Fibromyalgia. Handb Clin Neurol 2014;119:513-527.