Investigation of Stress, Anxiety, Depression and Sleep Quality in Patients with Ankylosing Spondylitis during the COVID-19 Pandemic

Yıl 2023, Cilt: 8 Sayı: 2, 471 - 475, 21.06.2023

Yasemin Acar , Nursen İlçin , İsmail Sarı

Öz

Objective: The aim of this study was to determine stress, anxiety, depression, and sleep disturbance in patients with ankylosing spondylitis (AS) during the COVID-19 pandemic and to examine the relationship between these psychiatric symptoms and disease activity/function.

Material and Method: A total of 54 patients with AS (29 males) were included in this cross-sectional study. The Bath AS Disease Activity Index (BASDAI) was used to assess disease activity, the Bath AS Functional Index (BASFI) was used to assess function, and the Bath AS Metrology Index (BASMI) was used to assess spinal mobility. Perceived stress of the patients was evaluated with the Perceived Stress Scale, anxiety and depression were evaluated with the Hospital Anxiety and Depression Scale, and sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI).

Results: It was determined that 50% of the patients had anxiety and 33.3% had depression. The PSQI score of the patients was 8.35 ± 0.58, and 68.5% had poor sleep quality. No relationship was found between BASDAI and stress, anxiety, depression, and sleep quality. There was a poor-moderate correlation between BASFI and sleep quality (r= 0.306, p=0.025).

Conclusion: During the COVID-19 pandemic, the rates of patients with AS who experienced various psychiatric problems such as stress, anxiety, depression, and sleep disorders were high. No relationship was found between disease activity and psychiatric symptoms. There was only a relationship between BASFI and sleep quality.

Anahtar Kelimeler

COVID-19, ankylosing spondylitis, stress, anxiety, depression, sleep quality

COVID-19 Pandemisinde Ankilozan Spondilit Hastalarında Stres, Anksiyete, Depresyon ve Uyku Kalitesinin İncelenmesi

Öz

Amaç: Bu çalışmanın amacı COVID-19 pandemisi sırasında ankilozan spondilit (AS) hastalarında stres, anksiyete, depresyon ve uyku bozukluğunun belirlenmesi ve bu psikiyatrik semptomlar ile hastalık aktivitesi/fonksiyon arasındaki ilişkinin incelenmesidir.

Gereç ve Yöntem: Kesitsel tipteki bu araştırmaya toplam 54 AS hastası (29 erkek) dahil edildi. Hastalık aktivitesinin değerlendirilmesinde Bath AS Hastalık Aktivite İndeksi (BASDAI), fonksiyonun değerlendirilmesinde Bath AS Fonksiyonel İndeksi (BASFI), spinal mobilitenin değerlendirilmesinde Bath Ankilozan Spondilit Metroloji İndeksi (BASMI) kullanıldı. Hastaların algıladıkları stres Algılanan Stres ölçeği ile, anksiyete ve depresyon Hastane Anksiyete ve Depresyon Ölçeği ile ve uyku kalitesi Pittsburgh Uyku Kalite İndeksi (PUKİ) ile değerlendirildi.

Bulgular: Hastaların %50’sinde anksiyete, % 33,3’ünde depresyon belirtileri olduğu tespit edildi. Hastaların ortalama PUKİ puanı 8,35 ± 0,58 idi ve % 68,5’i kötü uyku kalitesine sahipti. BASDAI ile stres, anksiyete, depresyon ve uyku kalitesi arasındaki ilişki incelendiğinde bir ilişki bulunmadı. BASFI ile uyku kalitesi arasında düşük-orta derecede korelasyon vardı (r= 0,306, p=0,025).

Sonuç: COVID-19 pandemisi sürecinde stres, anksiyete, depresyon ve uyku bozuklukları gibi çeşitli psikiyatrik belirtileri gösteren AS hastalarının oranlarının yüksek olduğu gözlendi. Hastalık aktivitesi ile psikiyatrik semptomlar arasında bir ilişki bulunmadı, yalnızca BASFI ile uyku kalitesi arasında bir ilişki vardı.

Anahtar Kelimeler

COVID-19, ankilozan spondilit, stres, anksiyete, depresyon, uyku kalitesi

Kaynakça

• Braun J, Sieper J. Ankylosing spondylitis. Lancet. 2007;369(9570):1379- 90. doi: https://doi.org/10.1016/S0140-6736(07)60635-7.
• Machado P, Landewé R, Braun J, Hermann K-GA, Baker D, van der Heijde D. Both structural damage and inflammation of the spine contribute to impairment of spinal mobility in patients with ankylosing spondylitis. Ann Rheum Dis. 2010;69(8):1465-70. doi: http://dx.doi. org/10.1136/ard.2009.124206.
• Durmus D, Sarisoy G, Alayli G, Kesmen H, Çetin E, Bilgici A, et al. Psychiatric symptoms in ankylosing spondylitis: their relationship with disease activity, functional capacity, pain and fatigue. Compr Psychiatry. 2015;62:170-7.
• Batmaz I, Sarıyıldız MA, Dilek B, Bez Y, Karakoç M, Çevik R. Sleep quality and associated factors in ankylosing spondylitis: relationship with disease parameters, psychological status and quality of life. Rheumatol Int. 2013;33(4):1039-45. doi: 10.1007/s00296-012-2513-2.
• Jiang Y, Yang M, Lv Q, Qi J, Lin Z, Liao Z, et al. Prevalence of psychological disorders, sleep disturbance and stressful life events and their relationships with disease parameters in Chinese patients with ankylosing spondylitis. Clin Rheumatol. 2018;37(2):407-14.
• Seyahi E, Poyraz BC, Sut N, Akdogan S, Hamuryudan V. The psychological state and changes in the routine of the patients with rheumatic diseases during the coronavirus disease (COVID-19) outbreak in Turkey: a web-based cross-sectional survey. Rheumatol Int. 2020;40(8):1229-38.
• Korucu TŞ, Seçer E, Özer Kaya D. COVID-19 Pandemisinde Ev İzolasyonunun Oluşturduğu Kas Ağrıları ve Postür Bozukluklarının Yönetiminde Temel Vücut Farkındalığı Terapisi. İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi.5(2):197-202.
• Johnstone G, Treharne GJ, Fletcher BD, Lamar RS, White D, Harrison A, et al. Mental health and quality of life for people with rheumatoid arthritis or ankylosing spondylitis in Aotearoa New Zealand following the COVID-19 national lockdown. Rheumatol Int. 2021;41(10):1763-72.
• Fernández-Ávila DG, Barahona-Correa J, Romero-Alvernia D, Kowalski S, Sapag A, Cachafeiro-Vilar A, et al. Impact of COVID-19 pandemic on patients with rheumatic diseases in Latin America. Rheumatol Int. 2022;42(1):41-9.
• GICA Ş, Akkubak Y, Aksoy ZK, Küçük A, Cüre E. Effects of the COVID-19 pandemic on psychology and disease activity in patients withankylosing spondylitis and rheumatoid arthritis. Turk J Med Sci. 2021;51(4):1631-9.
• Ingegnoli F, Buoli M, Posio C, Di Taranto R, Lo Muscio A, Cumbo E, et al. COVID-19 related poor mental health and sleep disorders in rheumatic patients: a citizen science project. BMC Psychiatry. 2021;21(1):1-9.
• Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol. 1994;21(12):2286-91.
• Zochling J. Measures of symptoms and disease status in ankylosing spondylitis: Ankylosing Spondylitis Disease Activity Score (ASDAS), Ankylosing Spondylitis Quality of Life Scale (ASQoL), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Global Score (BAS‐G), Bath Ankylosing Spondylitis Metrology Index (BASMI), Dougados Functional Index (DFI), and Health Assessment Questionnaire for the Spondylarthropathies (HAQ‐S). Arthritis Care Res (Hoboken). 2011;63(S11):S47-S58. doi: 10.1002/acr.20575.
• Calin A, Garrett S, Whitelock H, Kennedy LG, O’hea J, Mallorie P, 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(12):2281-5.
• Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983:385-96. doi: https://doi. org/10.2307/2136404.
• Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67(6):361-70. doi: https://doi. org/10.1111/j.1600-0447.1983.tb09716.x.
• Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28(2):193-213. doi: https:// doi.org/10.1016/0165-1781(89)90047-4.
• George D, Mallery P. IBM SPSS statistics 26 step by step: A simple guide and reference: Routledge; 2019.
• Hayran M. Sağlık araştırmaları için temel istatistik: Omega Araştırma; 2011.
• Liew JW, Castillo M, Zaccagnino E, Katz P, Haroon N, Gensler LS. Patient‐reported Disease Activity in an Axial Spondyloarthritis Cohort during the COVID‐19 Pandemic. ACR Open Rheumatol. 2020;2(9):533- 9.