The effect of axial spondyloarthritis on mental health: Results from the Atlas

Objective: To assess the risk for mental disorders in patients with axSpA and to examine the associated factors with this. Method: In 2016, a sample of 680 axSpA patients was interviewed as part of the development process for the Atlas of Axial Spondyloarthritis in Spain. The risk of mental disorders in these patients was assessed using the General Health Questionnaire (GHQ-12) scale. Additionally, the variables associated with the risk of mental disorders were investigated, including: sociodemographic characteristics (age, gender, relationship, association membership, job status, and educational level); disease status (BASDAI, spinal stiffness and functional limitation); and previous diagnosis of mental disorders (depression and anxiety). Bivariate correlation analyses were performed, followed by multiple hierarchical and stepwise regression analysis. Results: A total of 45.6% patients were at risk of mental disorders. All variables except educational level and thoracic stiffness significantly correlated with risk of mental disorder. Nevertheless, disease activity, functional limitation, and age showed the highest coefficient (r=0.543, p<0.001; r=0.378, p<0.001; r=-0.174, p<0.001, respectively). In the stepwise regression analysis, four variables (disease activity, functional limitation, association membership, and cervical stiffness) explained the majority of the variance for the risk of mental disorders. Disease activity displayed the highest explanatory degree (R2=0.875, p<0.001). Conclusions: In patients with axSpA, the prevalence of risk for mental disorders is high. Combined with a certain sociodemographic profile, high disease activity is a good indicator of the risk of for mental disorders.