Cooper-Moss, Nicola (2013) The cause and effect of mood disturbance in patients with ankylosing spondylitis. Masters thesis, Keele University.

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Ankylosing spondylitis (AS) is a chronic inflammatory disorder, causing progressive pain and stiffness of the spine and peripheral joints. A systematic review of the literature revealed a high prevalence of possible depression (23-36%) and possible anxiety (45- 57%) in patients with AS. However, few existing studies have focussed on the relationships between mood and AS severity.

612 participants in a UK cohort of AS patients were included in the baseline postal survey. 470 patients responded to the six month follow-up survey thereafter. Several measures of disease status were collected [disease activity (Bath AS Disease Activity Index), pain (numerical rating scale) and physical function (Bath AS Functional Index)]. Mood was assessed by the Hospital Anxiety and Depression Scale. Improvements or deteriorations in mood and disease status were defined according to minimal clinically important differences in each measure.

298/612 (49%) patients reported depression/anxiety at baseline. Of whom, 166/298 (56%) demonstrated a co-existence of depression and anxiety; 27/298 (9%) had depression only and 105/298 (35%) had anxiety only. Although depression and anxiety were individually associated with increased disease activity, the strongest association was observed in patients with mixed depression and anxiety (OR 7.66, 95% CI 4.10-14.30). Similarly, there were significant associations of mixed depression and anxiety with poor function (OR 5.91, 95% CI 3.17-10.99) and increased pain (OR 4.76, 95% CI 2.56-8.86). In contrast to clinical expectations, there was no association between changes in mood or disease status over six months.

There is a high prevalence and frequent co-occurrence of depression and anxiety in patients with AS. Findings suggested that AS patients with mixed depression and anxiety had increased disease severity, however longer follow-up studies of more than six months are required to investigate these causal relationships. Anxiety and depression, as well as disease severity, should be considered when treating patients with AS.

Item Type: Thesis (Masters)
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Contributors: Packham, J (Thesis advisor)
Depositing User: Lisa Bailey
Date Deposited: 16 Aug 2022 15:32
Last Modified: 16 Aug 2022 15:32

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