FRI0300 ARE COPING STRATEGIES, ANXIETY AND DEPRESSION ASSOCIATED WITH DAILY PHYSICAL ACTIVITY IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS?
Authors: M. Carbo, L. Overbeeke, S. Arends, Y. Kamsma, F. Wink, D. Paap, A. Spoorenberg
Journal: Annals of the Rheumatic Diseases (2020)

Background: Patients with axial spondyloarthritis (axSpA) who are more physically active experience less pain and better physical functioning. 1 Psychological factors such as anxiety and depression are associated with physical functioning and reduction of Quality of Life (QoL). 2 Furthermore, evasive coping strategies are commonly used in health-related coping. 3 However, as far as we know, no data is available regarding the influence of coping strategies, anxiety and depression on daily physical activity in axSpA. Objectives: To determine if coping strategies, anxiety and depression are associated with daily physical activity in patients with axSpA. Methods: Consecutive outpatients from the Groningen Leeuwarden AxSpA cohort (GLAS) participated in this study. Additionally to the standardized follow-up assessments, patients filled out the axSpA-Short Questionnaire to assess health-enhancing physical activity (axSpA-SQUASH), the Coping with Rheumatic Stressors (CORS) and the Hospital Anxiety and Depression Scale (HADS). Univariable and multivariable linear regression analyses were performed to explore associations of copings strategies, anxiety and depression, and patient- and disease related factors with daily physical activity. Additionally, patients were stratified into three tertiles of physical activity: low, intermediate and high. To identify group differences, Kruskal-Wallis test or Chi-Square test were used with post-hoc testing. Results: In total 85 patients were included; 59% were male, mean age was 49±14, median symptom duration 19.5 years (IQR 12.0-31.0), 71% were HLA-B27 positive and mean ASDAS was 2.1±1.0. Median axSpA-SQUASH total physical activity score was 9406.3 (IQR 5538.8–12081.3). Median scores of HADS-Anxiety (scale 7-28) and HADS-Depression (scale 7-28) were scores of 12 (IQR 10.0-14.0) and 10(IQR 9.0-12.5). The mostly frequently used coping strategie was comforting cognitions (for pain, range 9-36); median of 25.5 (IQR 22.0-28.0). Univariable analysis showed that lower daily physical activity was significantly associated with gender (female), higher disease activity (BASDAI), worse physical function (BASFI), worse quality of life (ASQoL), coping strategies ‘decreasing activities’ and ‘pacing’, higher depression score (HADS) and higher perceived influence of axSpA on general well-being. In multivariable analysis, only the coping strategy “decreasing activity” was independently associated with physical activity (β: -419.3, R 2 : 0.155, P&lt;0.001). Additionally, patients in the highest physical activity tertile were significantly more often male, had higher working status, lower BASDAI and ASDAS, better BASFI and ASQoL and scored lower on the coping strategy “decreasing activities”. Conclusion: In this cross-sectional study in axSpA patients with established disease, multiple patient and disease related factors were associated with daily physical activity. The evasive coping strategy ‘decreasing activities’ was the only independently associated factor. These findings suggest that to improve daily physical activity in axSpA patients attention should be paid not only on targeting disease activity, but also to other patient and disease related aspects, especially coping strategies used. References: [1]Regel A et al. RMD Open . 2017;3(1):e000397. [2]Kilic G et al. Med (United States ). 2014;93(29):e337. [3]Peláez-Ballestas I et al. Med (United States ). 2015;94(10):e600. Acknowledgments: The authors would like to thank all patients who participated in the GLAS cohort. Disclosure of Interests: Marlies Carbo: None declared, Laura Overbeeke: None declared, Suzanne Arends Grant/research support from: Grant/research support from Pfizer, Yvo Kamsma: None declared, Freke Wink Consultant of: Abbvie, Janssen, Davy Paap: None declared, Anneke Spoorenberg: None declared