THU0379 DEPRESSIVE SYMPTOMS AND FUNCTIONAL IMPAIRMENT ARE FREQUENT AND AFFECT QUALITY OF LIFE IN ANKYLOSING SPONDYLITIS AND PSORIATIC ARTHRITIS: A QUESTIONNAIRE-BASED ASSESSMENT OF 300 PATIENTS COMPARED WITH 150 PATIENTS WITH PSORIASIS AND 150 PATIENTS WITH MECHANICAL BACK PAIN
Authors: Natalie Frede, Sonja Hiestand, Franziska Schauer, Christoph Schempp, Georg Herget, Dominique Endres, Ludger Tebartz van Elst, Reinhard Voll, Jens Thiel, Nils Venhoff
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Axial ankylosing spondylitis (axSpA) and psoriatic arthritis (PsA) constitute chronic inflammatory conditions affecting the axial skeleton as well as peripheral joints. Insufficient treatment may lead to joint destruction associated with a high rate of disability. Extra-articular manifestations contribute to morbidity and a reduced quality of life. Furthermore, both, axSpA and PsA have been associated with an increased risk of depression. <h3>Objectives:</h3> The aim of this project was to assess quality of life, functional impairment in everyday life as well as the prevalence of depression in axSpA and PsA and determine associated factors. <h3>Methods:</h3> A questionnaire-based screening tool (FFbH, WHOQOL-BREF, Phq9, GHQ-12) was used to assess 150 patients with PsA and 150 patients with axSpA as well as 300 controls (150 with skin psoriasis only and 150 mechanical back pain patients) for quality of life, functional impairment as well as signs of depression. <h3>Results:</h3> Both, SpA and PsA patients had a significantly reduced health-related quality of life compared to published normal values as well as psoriasis only patients (p=0.0003). Pain and functional impairment in everyday life correlated highly with perceived overall quality of life (p&lt;0.01). Both, physical health as well as psychological health in turn highly correlated with the presence of depressive symptoms. In total, 35.4% of SpA and 41.2% of PsA patients had mild signs of depression, whereas 25% respectively 28.4% of SpA and PsA patients had moderate to severe signs of depression. Patients with active disease (BASDAI&gt;4) at the time of evaluation showed significantly more frequent depressive symptoms compared to patients with no or low disease activity (p&lt;0.0001). Female patients had a significantly reduced physical and psychological health-related quality of life compared to male patients (p=0.0003, respectively 0.0009). Female SpA and PsA patients also had significantly more depressive symptoms (p=0.0190). In our cohort, also age correlated with perceived quality of life. SpA and PsA patients &lt;45 years of age reported a significantly higher perceived overall quality of life compared to patients &gt;45 years (p&lt;0.0001). Quality of life regarding physical health, mental health as well as social relationships was significantly better in younger patients (p=0.0014, p=0.0109, p=0.0196 respectively). However, this did not translate into a reduced rate of depressive symptoms in young patients. Body mass index (BMI) was associated with reduced health-related quality of life and psychological wellbeing, but did not correlate with depression. Smoking was neither associated with quality of life nor depression. <h3>Conclusion:</h3> Despite treatment many SpA and PsA patients suffer from a reduced quality of life. Depression constitutes an important comorbidity, which needs to be addressed. Adequate therapy is not only important to reduce irreversible joint damage and disability but may also have a role in avoiding comorbidities such as depression. <h3>Disclosure of Interests:</h3> None declared