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

Yıl 2019, Cilt: 33 Sayı: 2, 129 - 137, 27.09.2019

Emrah Barışan Duygu Bayır Dilek Solmaz

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

Kaynakça

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