The Risk of Depressive Symptoms Increases in Radiographic Axial Spondyloarthritis Patients with Acute Anterior Uveitis

Abstract

Abstract Background This study aimed to assess the psychological status of radiographic axial spondyloarthritis (r-axSpA) patients with/without acute anterior uveitis (AAU) and to investigate whether the emotional status was different and associated with disease activity and other clinical variables. Patients and Methods This cross-sectional study included a total of 145 r-axSpA in-patients who fulfilled the modified New York criteria for ankylosing spondylitis. AAU was established by ophthalmologists. Clinical variables were collected from patient charts. All patients received a comprehensive rheumatologic assessment for disease activity, including the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS). The Short Form (SF)-36 Health Survey, the revised Self-Rating Anxiety Scale (SAS) and the revised Self-Rating Depression Scale (SDS) were applied to all participants by psychiatrists. Results Fifty-seven patients were diagnosed as having the first onset of AAU. Compared with the group of r-axSpA without AAU, the risk of depressive symptoms was higher in the group of r-axSpA with AAU (p=0.008). However, there was no significant difference in terms of the risk of anxious symptoms between these groups (p=0.868). In addition, r-axSpA patients with AAU had higher scores of ASDAS-C-reactive protein (ASDAS-CRP) but lower scores of ASDAS-erythrocyte sedimentation rate (ASDAS-ESR) (p=0.032 and p=0.019). Furthermore, there was a negative correlation between SDS scores and duration in r-axSpA patients with AAU. Among all patients, the group of r-axSpA with depressive symptoms had increased CRP levels and ASDAS-CRP scores and lower vitality in SF-36. Conclusion The risk of depressive symptoms increases in r-axSpA patients with AAU. Moreover, r-axSpA patients with uveitis had a higher disease activity as measured by ASDAS-CRP. Physicians should pay more attention to depressive symptoms and AAU in addition to the disease of r-axSpA itself.