AB0669 DEPRESSION AND ANXIETY MIGHT NOT BE INCREASED DURING COVID-19 PANDEMIC IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS
Authors: E. Erpek, D. Solmaz, D. Bayraktar, G. Duran, G. Kabadayi, E. Durak Ediboglu, E. Otman Akat, G. Alp, H. Cinakli, İ. Kurut Aysin, S. Gucenmez, O. Bayindir, M. Ozmen, S. Akar
Journal: Annals of the Rheumatic Diseases (2021)

Background: Anxiety and depression are most common psychiatric disorders in chronic inflammatory rheumatic condition as well as axial spondyloarthritis (axSpA) (1). The prevalence of depression has been reported as 11-64% depending on the criteria used. Also self-reported depression and anxiety were found to be associated with disease activity and function in axSpA (1,2). It is observed that mental health is affected among healthy subjects during the COVID-19 pandemic, but this condition has not been systematically reviewed in axSpA patients. Objectives: We aimed to compare frequency of self-reported depression and anxiety before and during the Covid-19 pandemic in patients with axSpA. Methods: Seventy-six axSpA patients who were evaluated for the presence of depression and anxiety by using Hospital Anxiety and Depression scale (HADs) before pandemic were included in this study. All participants were classified according to the ASAS axSpA classification criteria. Patients were contacted by phone to participate and complete the HADS questionnaire. Demographic and disease related characteristics including BASDAI, BASFI and Patient Acceptable Symptom State (PASS) were recorded during interview. The HADs cut off value was taken as &gt;7 in both groups to define the presence of anxiety or depression. Before and during pandemic period anxiety and depression scores were statistically compared. Results: The demographic and disease related characteristics of axSpA patients with and without anxiety/depression were summarized in Table 1. The frequency of anxiety (43.4% vs %43.4; p&gt;0.05) and depression (46.1% vs 44.7%; p&gt;0.05) were found to be similar before and during pandemic period. Patients with anxiety (HADs&gt;7) and depression (HADs&gt;7) had higher BASDAI and BASFI scores and much less PASS positivity (Table 1). Although the frequency of depression was similar between before and during the pandemic period, symptom severity in depression was slightly increased during the pandemic (Figure 1). Table 1. Patients’ demographics and characteristics according to the presence of anxiety and depression Variables Presence of depression n:35 Absence of depression n:41 P Presence of anxiety n:33 Absence of anxiety n:43 P Age (years) mean ± SD 41.8±11.2 44.1±9.3 &gt;0.05 42.0±10.9 43.6±10.0 &gt;0.05 Male n(%) 21(60.0) 26(63.4) &gt;0.05 18(54.5) 29(67.4) &gt;0.05 Education time (years) mean ± SD 9.6±4.8 11.0±4.2 &gt;0.05 9.7±5.0 10.6±4.1 &gt;0.05 Current smoker n(%) 18(51.4) 15(36.6) &gt;0.05 15(45.5) 18(41.9) &gt;0.05 Alcohol consumption n(%) 12(34.3) 12(29.3) &gt;0.05 10(30.3) 14(32.6) &gt;0.05 Current BMI kg/m 2 mean ± SD 26.0±4.8 26.8±4.5 &gt;0.05 26.4±5.0 26.5±4.3 &gt;0.05 Sleep time (hours) mean ± SD 7.6±1.7 7.6±1.3 &gt;0.05 7.5±1.6 7.7±1.4 &gt;0.05 Current BASDAI mean ± SD 2.5±1.6 1.4±1.6 &lt;0.05 2.7±1.8 1.3±1.3 &lt;0.001 Current BASFI mean ± SD 2.4±2.1 1.1±1.3 &lt;0.05 2.4±2.0 1.2±1.4 &lt;0.05 PASS positivity n(%) 16(45.7) 29(70.7) &lt;0.05 14(42.4) 31(72.1) &lt;0.05 Current depression and anxiety scores were correlated with disease activity (HADs Depression vs BASDAI r:0.530, p&lt;0.001; HADs Anxiety vs BASDAI r:0.500, p&lt;0.001) and function (HADs-Depression vs BASFI r:0.519, p&lt;0.001; HADs-Anxiety vs BASFI r:0.391, p&lt;0.001). These relationships were also observed in the pre-pandemic period (HADs-Depression vs BASFI r:0.326, p&lt;0.05; HADs-Anxiety vs BASDAI r:0.342, p&lt;0.05). Conclusion: Depression and anxiety symptoms seems to be comparable before and after the COVID-19 pandemic. Regardless of this period, the presence of both depression and anxiety are associated with disease activity, function and less patient acceptable symptom state. References: [1]Zhao S, Thong D, Miller N, et al. The prevalence of depression in axial spondyloarthritis and its association with disease activity: a systematic review and meta-analysis. Arthritis Res Ther. 2018;20:140. [2]Barişan E, Bayir D, Solmaz D. Aksiyel spondiloartrit hastalarinda anksiyete düzeyinin çeşitli ölçeklerle değerlendirilmesi ve anksiyete ile ilişkili faktörler. Dokuz Eylül Üniversitesi Tip Fakültesi Dergisi. 2019; 129-137. Figure 1. Disclosure of Interests: None declared