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Patients' ankylosing spondylitis perceptions shaped by helplessness, depression

Patients' ankylosing spondylitis perceptions shaped by helplessness, depression

Some psychological factors—helplessness and depression—account for significant variability in perceived disease activity in patients with ankylosing spondylitis (AS). Because medical variables—such as C-reactive protein (CRP) level and radiographic severity—are not associated with patient-reported disease activity, interpretation of AS disease status may need to occur in the context of evaluating psychological status.

Brionez and colleagues conducted a cross-sectional study of patients with AS from the Prospective Study of Outcomes in Ankylosing Spondylitis. Measurement of disease activity was achieved with the Bath AS Disease Activity Index (BASDAI), a self-report 6-item questionnaire. Medical variables included CRP level, number of patient-reported comorbidities, and disease duration. Six psychological variables were measured.

Psychological variables contributed significantly to variance in BASDAI scores, adding 33% to the overall R-square beyond that accounted for by demographic and medical variables. Arthritis helplessness and depression accounted for the most significant portion of variance in BASDAI scores; other psychological factors—internality and passive, active, and resilience coping—did not account for significant variance.

The authors noted that their findings have important clinical implications and suggest potential avenues of intervention.

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