Study: People With Ankylosing Spondylitis Are More Likely to Experience Depression and Anxiety

Mar 2, 2020 | Research | 0 comments

Title of Study: “The incidence of depression and anxiety in patients with ankylosing spondylitis: a systematic review and meta-analysis”


Published: 2nd March, 2020 | Link: View study here | Authors:Jamie YE. Park, Alyssa M. Howren, Enav Z. Zusman, John M. Esdaile & Mary A. De Vera


In Summary:

  • AS patients are at a 51% higher risk of depression compared to those without AS
  • One study reported an 85% increased risk in AS patients (though this is less studied)
  • Disease severity, quality of life and smoking were also factors


Fundamental Findings:

This study looked at depression and anxiety among patients with AS and found an increased risk for both conditions.

The researchers performed what’s called a ‘systematic review’ of existing literature on AS patients.

That means they focused on existing studies that assessed depression and/or anxiety in AS patients. These results were then pooled to create a fuller picture of mental health risks associated with AS.

Out of 783 titles in their search, the researchers reviewed 39 manuscripts.

They found that overall AS patients had a 51% higher risk of developing depression, compared to those who didn’t have it.

The risk of anxiety was less studied, and there was only one included study. This study reported an 85% increased risk.

They found that lower education levels were a key factor with higher odds of depression and anxiety in AS patients with less formal education.

The increased risk of depression and anxiety in AS patients is down to a variety of factors but includes the inflammatory nature of the disease.

It has been linked to higher levels of proinflammatory cytokines. These cytokines have also been shown to be high in patients with depression and anxiety.

Sex-specific risk estimates for depression and anxiety were inconclusive.

Other factors that contributed to depression and anxiety among AS patients were: disease severity, quality of life, and smoking.

Study Snapshots

Here are some direct quotes from the study:

Background: “As awareness for the importance of mental health continues to expand in rheumatology, it is important to understand the epidemiology of psychiatric complications in ankylosing spondylitis (AS) with the ultimate goal of future prevention and improved quality of care. This study aims to review evidence on the incidence and determinants of depression and/or anxiety among patients with AS.”

Results: “Out of 783 titles from our search strategy, we reviewed 39 manuscripts. Four studies assessed the incidence of depression and meta-analyzing reported estimates from three of these studies yielded a pooled RR of 1.51 (95% CI 1.28 to 1.79). Differences in risk of depression among men and women with AS were inconclusive, suggesting need for further study. The incidence of anxiety was comparatively less studied with only one included study reporting a hazard ratio of 1.85 (95% CI 1.37 to 2.49). Education level was a key determinant, with lower levels associated with higher odds of depression (OR 6.65; 9% CI 1.36 to 32.51) and anxiety (OR 9.31; 9% CI 1.39 to 62.19) among AS patients.”

Conclusion: “Our systematic review and meta-analysis shows an increased risk of depression and anxiety among patients with AS. These findings suggest the importance of monitoring and care for psychiatric conditions in AS.”

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