Abstract
IntroductionFunctional status is an integral component of health-related quality of life in patients with ankylosing spondylitis (AS). The purpose of this study was to investigate the role of psychological variables in self-reported functional limitation in patients with AS, while controlling for demographic and medical variables.Methods294 AS patients meeting modified New York Criteria completed psychological measures evaluating depression, resilience, active and passive coping, internality and helplessness at the baseline visit. Demographic, clinical, and radiologic data were also collected. Univariate and multivariate analyses were completed to determine the strength of correlation of psychological variables with functional limitation, as measured by the Bath AS Functional Index (BASFI).ResultsIn the multivariate regression analysis, the psychological variables contributed significantly to the variance in BASFI scores, adding an additional 24% to the overall R-square beyond that accounted by demographic and medical variables (R-square 32%), resulting in a final R-square of 56%. Specifically, arthritis helplessness, depression and passive coping beside age, ESR and the Bath AS Radiograph Index accounted for a significant portion of the variance in BASFI scores in the final model.ConclusionsArthritis helplessness, depression, and passive coping accounted for significant variability in self-reported functional limitation beyond demographic and clinical variables in patients with AS. Psychological health should be examined and accounted for when assessing functional status in the AS patients.
Highlights
Functional status is an integral component of health-related quality of life in patients with ankylosing spondylitis (AS)
Arthritis helplessness, depression and passive coping beside age, ESR and the Bath AS Radiograph Index accounted for a significant portion of the variance in Bath AS Functional Index (BASFI) scores in the final model
Arthritis helplessness, depression, and passive coping accounted for significant variability in self-reported functional limitation beyond demographic and clinical variables in patients with AS
Summary
Functional status is an integral component of health-related quality of life in patients with ankylosing spondylitis (AS). Two prior studies, examining the role of psychological factors in AS functional limitation, found functional disability, measured by the Bath AS Functional Index (BASFI), to be associated with higher depression scores and lower internality scores in a UK AS population, and depression to be highly correlated with work disability and unemployment in an Argentinean AS population [15,16]. These studies examined only a limited number of potential variables and did not use multivariate analyses to account for the confounding effect of multiple baseline variables when they are examined simultaneously
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