Background/Purpose: This study’s aim was to assess the association between sociodemographic characteristics, disease progression, and mental health comorbidity with risk of mental disorders (RMD).

Methods: In 2016 a sample of 680 axSpA patients was interviewed as part of the Spanish Atlas. To quantify the RMD, Goldberg’s General Health Questionnaire (GHQ-12) scale was employed. Possible RMD predictors analysed were: sociodemographic characteristics (age, gender, being part of a couple, patient association membership, job status); disease characteristics (BASDAI, spinal stiffness ranging from 0-3, functional limitation in 18 daily activities ranging from 0-3); and mental health comorbidities (depression and anxiety). All clinical variables showed a Cronbach’s alpha coefficient guaranteeing the reliability of the scales used. First, a descriptive analysis was employed to describe the sample and study variables. Second, we performed univariate correlation and homogeneity analyses between each predictor (independent variable) and RMD (GHQ-12). Third, selection of variables that showed statistical significance in the univariate analyses in order to conduct a multiple hierarchical and stepwise regression analysis.

Results: All variables except educational level and thoracic stiffness showed significant univariant correlation with RMD. BASDAI, functional limitation and age showed higher coefficient (R = 0.543, R = 0.378, R = -0.174, respectively). Multiple Hierarchical regression analysis showed as sociodemographic variables explained in great detail the RMD (R² = 83.2%). By contrast, having established sociodemographic as a control variable, the inclusion of depression and anxiety to the model increase the R² value to just 0.6% (p = 0.001), while the inclusion of variables related to the disease characteristics add 5.5% (p = 0.000) to the GHQ-12 punctuation variability. The only variables presenting a significant coefficient different from 0 were BASDAI (0.52, p = 0.000) and functional limitation (0.14, p = 0.004). This suggests that once the sociodemographic and mental commorbidity variables are established, a change to BASDAI levels or functional limitation impacts the GHQ-12 score. In the stepwise regression analysis, four variables (BASDAI, functional limitation, association membership, cervical stiffness) showed a significant relation to GHQ-12 and explained the majority of RMD variability. BASDAI displayed the highest explanatory degree (R² = 0.875).

Table 1. Sample characteristics (n = 474, unless other specified).

Conclusion: Patients at certain sociodemographic levels are more prone to present a higher BASDAI. Taking these conditions for granted, the degree of disease progression measured by BASDAI is a good indicator of RMD. Therefore, in those with higher disease activity, psychiatric evaluation and intervention should be considered within the medical treatment.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/mental-health-in-patients-with-axial-spondyloarthritis-increasing-our-understanding-of-the-disease-results-from-the-spanish-atlas/