Aksiyel spondiloartrit hastalarında anksiyete düzeyinin çeşitli ölçeklerle değerlendirilmesi ve anksiyete ile ilişkili faktörler

Öz

Amaç: Uluslararası spondiloartrit topluluğu (Assesment in SpondyloArthritis International Society; ASAS) tarafından önerilen aksiyel spondiloartrit (akSpA) konsepti içerisinde ankilozan spondilit (AS) hastalarının yanı sıra direkt grafide belirlenen kriterleri karşılamayan ancak manyetik rezonans görüntüleme  veya diğer klinik özellikleri ile non-radyografik aksiyel spondiloartrit (nr-akSpA) olarak sınıflandırılan hastalar da yer almaktadır. Bu iki grup bazı özellikler açısından farklılıklar göstermesine karşın hastalık aktivitesi ve yaşam kalitesi açısından benzer hastalık yükünü taşımaktadır. Bu hastalık grubunda psikiyatrik semptomlar sıklıkla görülmekte ve en sık tanımlanan bozukluklar arasında anksiyete ve depresyon yer almaktadır. Bu çalışmada akSpA hastalarında anksiyetenin çeşitli ölçeklerle değerlendirilmesi ve ilişkili olabileceği faktörlerin gözden geçirilmesi planlanmıştır.

Gereç ve Yöntem: Çalışmaya ASAS tanımlamasına göre akSpA olarak sınıflandırılan 155 [124 (%80,0) AS, 31 (%20,0) nr-akSpA] hasta dahil edilmiştir. Psikiyatrik semptomların değerlendirilmesi için State-Trait Anxiety inventory (STAI) 1 ve 2, Beck depresyon envanteri ve Beck anksiyete envanteri kullanılmıştır. Anksiyete ile ilişkili olabilecek bağımsız faktörler için lojistik regresyon analizi uygulanmıştır.

Bulgular: AS hastaların nr-akSpA’ya göre karşılaştırıldığında daha yaşlı (39 ±10,8 vs 35 ±10,1 p=0,035) ve daha fazla sayıda erkek hastadan (%73,4 vs %54,8, p=0,044) oluştuğu görülmüştür. Aksiyel spondiloartritte anksiyete sıklığı %60,8, depresyon sıklığı ise %27 olarak saptanırken AS ve nr-akSpA gruplarında farklılık saptanmamıştır. Kadın cinsiyet (Odds ratio [OR]= 2,8, p=0,032) ve yüksek hastalık aktivitesi (Bath Ankilozan Spondilit Aktivite İndeksi ≥4) (OR=1,44, p=0,034) anksiyeteyi bağımsız belirleyen faktörler olarak bulunmuştur.

Sonuç: Aksiyel Spondiloartrit hastalarında anksiyete ve depresyon önemli sıklıklarda bulunmakta ve alt gruplarında da benzer oranlarda görülmektedir. Anksiyete varlığı kadın cinsiyet ve yüksek hastalık aktivitesi ile ilişkili olarak bulunmuştur.

Anahtar Kelimeler

• aksiyel spondiloartrit,ankilozan spondilit,anksiyete

EVALUATION OF ANXIETY LEVEL WITH DIFFERENT SCALES AND ITS RELATED FACTORS IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS

Öz

Objective:  The concept of axial spondyloarthritis (axSpA) recommended by the Assesment in SpondyloArthritis International Society (ASAS) includes patients with ankylosing spondylitis (AS), and non-radiographic axSpA (nr-axSpA). Non-radiographic axSpA group is more heterogeneous, and distinct from AS in terms of some clinical characteristics. However, they have similar disease burden in terms of disease activity and quality of life.  Psychiatric symptoms can often be seen during the disease course in both. Anxiety and depression are most common psychiatric disorders in these patients groups. In this study, we aim to assess the anxiety level and its related factors in axSpA patients.

Material and Method: One hundred fifty-five [124 (80.0%) AS, 31 (20.0%) nr-axSpA] patients with axSpA according to the ASAS definition were included in this study. The State-Trait Anxiety inventory (STAI-1 and 2), Beck Depression Inventory and Beck Anxiety Inventory were used to define psychiatric symptoms. A logistic regression analysis was performed for determining independent predictors related with anxiety.

 Results: Patients with AS were more frequently males (73.4% vs 54.8%, p=0.044) and significantly younger (mean age =39 ±10.8 vs vs 35 ±10.1years, p=0.035] compared to patients with nr-axSpA. In axSpA, the frequency of anxiety was found as 60.8% and the frequency of depression was found as 27%, while there was no difference between AS and nr-axSpA groups. Female gender (Odds ratio [OR]= 2.8, p= 0.032) and high disease activity (Bath Ankylosing Spondylitis Activity Index≥ 4) (OR= 1.44, p= 0.034) were found to be independent predictors of anxiety.

Conclusion: The frequency of anxiety and depression is found to be high in patients with axSpA, and both have been similar frequencies within disease subgroups. Female gender and higher disease activity have been shown as significant predictors of anxiety in axSpA patients

Anahtar Kelimeler

• axial spondyloarthritis,ankylosing spondylitis,anxiety

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