FRI0198 Which factors influence psychological well-being of patients with axial spondyloarthritis? – data from a cross-sectional survey linked to insurance claims
Authors: I. Redeker, F. Hoffmann, J. Callhoff, H. Haibel, J. Sieper, A. Zink, D. Poddubnyy
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Psychological well-being is considered an important determinant of quality of life. Importantly, well-being is related not only to medical factors, but also to social and economic factors. <h3>Objectives</h3> The aim of this study was to examine the psychological well-being of patients with axial spondyloarthritis (axSpA) and its determinants. <h3>Methods</h3> A stratified random sample of subjects with a diagnosis of axSpA (International Classification of Diseases, Tenth Revision, [ICD-10] code M45) was drawn from German health insurance data to whom a postal questionnaire was sent asking about disease-related, psychological, and lifestyle factors as well as socioeconomic status. Additional information to verify the axSpA diagnosis was collected. The psychological well-being was assessed by the World Health Organisation Well-Being Index (WHO-5), which is considered a sensitive and specific screening tool for depression. The following established cut-offs on the WHO-5 were applied:&gt;50: good well-being, no depressive symptoms, 29–50: mild depressive symptoms,≤28: moderate-to-severe depressive symptoms. Information on comorbidities, drug prescriptions and non-pharmacological treatment was retrieved from claims data and linked to the questionnaire data. <h3>Results</h3> A total of 1736 persons with a confirmed axSpA diagnosis were included; mean age was 55.8 years and 46.3% were female. We found a mean WHO-5 score of 44.70 in axSpA subjects, which is considerably below the WHO-5 score of 69.95 reported among the population in Germany aged 41 to 60 years.<sup><sup>1</sup></sup> Using the cut-offs on the WHO-5, 533 persons (31%) were found to have moderate-to-severe depressive symptoms, 479 (28%) had mild depressive symptoms, and 724 (42%) had a good well-being. Persons with moderate-to-severe depressive symptoms had higher disease burden of axSpA, lower household income and reported more often a lack of exercise and a perception of suffering from stress (table 1). Multivariable logistic regression revealed that higher disease activity of axSpA, higher level of functional impairment, lower income, self-reported stress and lack of exercise, and younger age were associated with moderate-to-severe depressive symptoms. <h3>Conclusions</h3> Moderate-to-severe depressive symptoms are frequent in patients with axSpA. They are associated with a high disease burden as well as sociodemographic factors. These findings highlight the need for the careful evaluation of depressive symptoms as a part of the management strategy for axSpA, helping to improve axSpA outcomes. <h3>Reference</h3> [1] Brähler E, Mühlan H, Albani C, Schmidt S. Teststatistische Prüfung und Normierung der deutschen Versionen des EUROHIS-QOL Lebensqualität-Index und des WHO-5 Wohlbefindens-Index. Diagnostica 2007;53(2):83–96. <h3>Acknowledgements</h3> This work was supported by the Federal Ministry of Education and Research within the research network PROCLAIR (01EC1405). <h3>Disclosure of Interest</h3> None declared