Prevalence of Depression and Anxiety in Syrian Patients with Ankylosing Spondylitis: Associations with Disease-Related Factors, Fatigue, Quality of Life, and Sleep Disturbance - A Cross-Sectional Study

Abstract

Abstract Background AS Patients are a vulnerable group to mood disorders due to the high burden of their disease and its impact on physical function and quality of life. Identifying risk factors for depression and anxiety is essential for at-risk groups to better outcomes. This study aims to assess the prevalence of depression and anxiety among Syrian AS patients and identify predictive factors. Methods This cross-sectional study was conducted using convenience sampling at the biological treatment unit of the rheumatology department in Damascus Hospital. Data were collected from face-to-face interviews with patients using validated structural questionnaires which included socio-demographics, disease characteristics variables, and different measures in order to assess disease activity (ASDAS, BASDAI), physical function and general health (BASFI, BASG), fatigue (FACIT Fatigue Scale), quality of life (ASQoL), depression (PHQ-9), anxiety (GAD-7), and sleep disturbance (JSS). A multiple linear regression model was used to investigate potentially predictive factors for depression and anxiety. Results Out of 103 patients, the majority were male 82 (79.6%), 40 (38.8%) quitted working due to disease, and 25 (24.3%) had a positive history of both depression and anxiety. 51 (49.5%) of patients showed clinically significant depression while clinically significant anxiety was identified by 38 (36.9%) of patients. Contextual and disease-related factors associated with depression and anxiety were quitting work due to disease, hip pain, and a positive history of mental distress. Disease activity scores were associated with both depression and anxiety but with low explanatory power. Significant association with relatively high explanatory power demonstrated between both depression and anxiety with poor quality of life, sever fatigue, and high frequency of sleep disturbance. Conclusion This study demonstrates high levels of depression and anxiety among Syrian AS patients, along with a high frequency of fatigue and sleep disturbance. Poor Quality of life, sever fatigue, and high frequency sleep disturbance are considered major predictive factors for depression and anxiety. Healthcare providers should pay more attention to depressive and anxiety symptoms in the course of AS patient management.