AB0874 Mental health disorders in patients with axial spondyloarthritis: increasing our understanding of the disease. results from the atlas-2017
Authors: M. Garrido-Cumbrera, V. Navarro-Compan, D. Gálvez-Ruiz, C. Delgado-Dominguez, P. Font Ugalde, O. Braçe, P. Zarco, J. Chacón-García, P. Plazuelo-Ramos
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Depression and other mental disorders are among the most prevalent comorbidities in patients with axial spondyloarthritis (axSpA). <h3>Objectives</h3> To assess the association between sociodemographic characteristics, disease progression, and mental health comorbidity with risk of mental disorders (RMD). <h3>Methods</h3> <sup>In 2016 a</sup> sample of 680 axSpA patients was interviewed as part of the Spanish Atlas. To quantify the RMD, GHQ-12 scale was employed. Possible RMD predictors taken into account in the analysis were: sociodemographic characteristics (age, gender, being part of a couple, patient association membership, job status); disease characteristics (BASDAI, spinal stiffness, functional limitation in 18 daily activities; and mental health comorbidities. 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, univariate correlation and homogeneity analyses between each predictor (independent variable) and RMD (GHQ-12) were performed. <h3>Results</h3> 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, p&lt;0.001; r=0.378, p&lt;0.001; r=−0.174, p&lt;0.001, respectively). Multiple hierarchical regression analysis showed as sociodemographic variables explained in great detail the RMD (R<sup>2=</sup>83.2%). By contrast, having established sociodemographic as a control variable, the inclusion of depression and anxiety to the model increased the R<sup>2</sup> value to just 0.6% (p<i>&lt;</i>0.001), while the inclusion of variables related to the disease characteristics add 5.5% (p<i>&lt;</i>0.001) to the GHQ-12 punctuation variability. The only variables presenting a significant coefficient different from 0 were BASDAI (0.52, p<i>&lt;</i>0.001) and functional limitation (0.14, p<i>&lt;</i>0.01). This suggests that once the sociodemographic and mental commorbidity variables are established, a change in 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 (R<sup>2</sup>=0.875, p&lt;0.001). <h3>Conclusions</h3> In axSpA, 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 patients with higher disease activity, psychiatric evaluation and intervention should be considered within the medical treatment. <h3>Acknowledgements</h3> The Atlas was promoted by CEADE and funded by Novartis <h3>Disclosure of Interest</h3> None declared