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Erschienen in:

10.03.2021

Gender differences in factors associated with low quality of life and depression in Korean patients with ankylosing spondylitis

verfasst von: Bora Nam, Bon San Koo, Seoung Wan Nam, Ji-Hui Shin, Yoonah Song, Soo-Kyung Cho, Yoon-Kyoung Sung, Tae-Hwan Kim

Erschienen in: Quality of Life Research | Ausgabe 8/2021

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Abstract

Purpose

To identify predictors of low health-related quality of life (HRQoL) and depression in ankylosing spondylitis (AS) patients with a focus on gender differences.

Methods

We conducted a cross-sectional cohort study. Both AS-related clinical data and contextual factors were obtained. HRQoL and depressive mood were assessed by EuroQol-5 dimension (EQ-5D) and the Center for Epidemiological Studies Depression Scale (CES-D), respectively. Gender-stratified multivariable logistic regression analyses were performed.

Results

Among 211 patients, 161 were males. Males had similar disease activity and higher radiographic damage compared with females. There was no significant difference in EQ-5D index score between genders. CES-D score was higher in females. Higher ASDAS-C-reactive protein (CRP) was associated with low HRQoL in both males (Odds ratio [OR] 4.25, 95% confidence interval [CI] 2.42–7.46) and females (OR 2.94, 95% CI 1.02–8.48). Being employed was associated with decreased possibility of having low HRQoL in males (OR 0.39, 95% CI 0.16–0.95). Regarding depression, higher ASDAS-CRP (OR 1.87, 95% CI 1.03–3.40), current smoking (OR 2.98, 95% CI 1.09–8.15), and being employed (OR 0.17, 95% CI 0.06–0.46) were associated with depression in males. For females, living with a partner was related to depression (OR 0.08, 95% CI 0.01–0.93).

Conclusion

AS patients with high disease activity are likely to be suffering from low HRQoL. Both disease-related factors and contextual factors were associated with depression, and predictors showed some differences between genders. Awareness of gender differences in comprehensive assessment can lead us to better personalized management in AS patients.

Braun, J., & Sieper, J. (2007). Ankylosing spondylitis. Lancet, 369(9570), 1379–1390.PubMedCrossRef

Lee, W., Reveille, J. D., Davis, J. C., Jr., Learch, T. J., Ward, M. M., & Weisman, M. H. (2007). Are there gender differences in severity of ankylosing spondylitis? Results from the PSOAS cohort. Annals of the Rheumatic Diseases, 66(5), 633–638.PubMedCrossRef

van Tubergen, A., Ramiro, S., van der Heijde, D., Dougados, M., Mielants, H., & Landewe, R. (2012). Development of new syndesmophytes and bridges in ankylosing spondylitis and their predictors: A longitudinal study. Annals of the Rheumatic Diseases, 71(4), 518–523.PubMedCrossRef

Ramiro, S., Stolwijk, C., van Tubergen, A., van der Heijde, D., Dougados, M., van den Bosch, F., & Landewe, R. (2015). Evolution of radiographic damage in ankylosing spondylitis: A 12 year prospective follow-up of the OASIS study. Annals of the Rheumatic Diseases, 74(1), 52–59.PubMedCrossRef

Rusman, T., van Vollenhoven, R. F., & van der Horst-Bruinsma, I. E. (2018). Gender differences in axial spondyloarthritis: Women are not so lucky. Current Rheumatology Reports, 20(6), 35.PubMedPubMedCentralCrossRef

Kotsis, K., Voulgari, P. V., Drosos, A. A., Carvalho, A. F., & Hyphantis, T. (2014). Health-related quality of life in patients with ankylosing spondylitis: A comprehensive review. Expert Review of Pharmacoeconomics & Outcomes Research, 14(6), 857–872.CrossRef

Yang, X., Fan, D., Xia, Q., Wang, M., Zhang, X., Li, X., Cai, G., Wang, L., Xin, L., Xu, S., & Pan, F. (2016). The health-related quality of life of ankylosing spondylitis patients assessed by SF-36: A systematic review and meta-analysis. Quality of Life Research, 25(11), 2711–2723.PubMedCrossRef

Martindale, J., Shukla, R., & Goodacre, J. (2015). The impact of ankylosing spondylitis/axial spondyloarthritis on work productivity. Best Practice & Research Clinical Rheumatology, 29(3), 512–523.CrossRef

Park, J. Y., Howren, A. M., Zusman, E. Z., Esdaile, J. M., & De Vera, M. A. (2020). The incidence of depression and anxiety in patients with ankylosing spondylitis: A systematic review and meta-analysis. BMC Rheumatology, 4, 12.PubMedPubMedCentralCrossRef

10.

Zhang, L., Wu, Y., Liu, S., & Zhu, W. (2019). Prevalence of depression in ankylosing spondylitis: A systematic review and meta-analysis. Psychiatry Investigation, 16(8), 565–574.PubMedPubMedCentralCrossRef

11.

Lowe, B., Willand, L., Eich, W., Zipfel, S., Ho, A. D., Herzog, W., & Fiehn, C. (2004). Psychiatric comorbidity and work disability in patients with inflammatory rheumatic diseases. Psychosomatic Medicine, 66(3), 395–402.PubMed

12.

Sundquist, K., Li, X., Hemminki, K., & Sundquist, J. (2008). Subsequent risk of hospitalization for neuropsychiatric disorders in patients with rheumatic diseases: A nationwide study from Sweden. Archives of General Psychiatry, 65(5), 501–507.PubMedCrossRef

13.

Ertenli, I., Ozer, S., Kiraz, S., Apras, S. B., Akdogan, A., Karadag, O., Calguneri, M., & Kalyoncu, U. (2012). Infliximab, a TNF-alpha antagonist treatment in patients with ankylosing spondylitis: The impact on depression, anxiety and quality of life level. Rheumatology International, 32(2), 323–330.PubMedCrossRef

14.

Barlow, J. H., Macey, S. J., & Struthers, G. R. (1993). Gender, depression, and ankylosing spondylitis. Arthritis Care and Research, 6(1), 45–51.PubMedCrossRef

15.

Law, L., Beckman Rehnman, J., Deminger, A., Klingberg, E., Jacobsson, L. T. H., & Forsblad-d’Elia, H. (2018). Factors related to health-related quality of life in ankylosing spondylitis, overall and stratified by sex. Arthritis Research & Therapy, 20(1), 284.CrossRef

16.

Verma, R., Balhara, Y. P., & Gupta, C. S. (2011). Gender differences in stress response: Role of developmental and biological determinants. Industrial Psychiatry Journal, 20(1), 4–10.PubMedPubMedCentral

17.

van der Linden, S., Valkenburg, H. A., & Cats, A. (1984). Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis & Rheumatism, 27(4), 361–368.CrossRef

18.

Nam, S. W., Sung, Y.-K., Kim, D., Cho, S.-K., Song, Y., Choi, Y. Y., Sim, Y., & Kim, T.-H. (2020). The usefulness of trabecular bone score in patients with ankylosing spondylitis. The Korean Journal of Internal Medicine. https://doi.org/10.3904/kjim.2020.065.

19.

Creemers, M. C., Franssen, M. J., van’t Hof, M. A., Gribnau, F. W., van de Putte, L. B., & van Riel, P. L. (2005). Assessment of outcome in ankylosing spondylitis: An extended radiographic scoring system. Annals of the Rheumatic Diseases, 64(1), 127–129.PubMedCrossRef

20.

Averns, H. L., Oxtoby, J., Taylor, H. G., Jones, P. W., Dziedzic, K., & Dawes, P. T. (1996). Radiological outcome in ankylosing spondylitis: Use of the Stoke ankylosing spondylitis spine score (SASSS). British Journal of Rheumatology, 35(4), 373–376.PubMedCrossRef

21.

Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.CrossRef

22.

Group, T. E. (1990). EuroQol—A new facility for the measurement of health-related quality of life. Health Policy, 16(3), 199–208. CrossRef

23.

Thombs, B. D., Hudson, M., Schieir, O., Taillefer, S. S., Baron, M., & Canadian Scleroderma Research, G. (2008). Reliability and validity of the center for epidemiologic studies depression scale in patients with systemic sclerosis. Arthritis & Rheumatism, 59(3), 438–443.CrossRef

24.

Rhee, S. H., Petroski, G. F., Parker, J. C., Smarr, K. L., Wright, G. E., Multon, K. D., Buchholz, J. L., & Komatireddy, G. R. (1999). A confirmatory factor analysis of the Center for Epidemiologic Studies Depression Scale in rheumatoid arthritis patients: Additional evidence for a four-factor model. Arthritis Care and Research, 12(6), 392–400.PubMedCrossRef

25.

Kim, M. H., Cho, Y. S., Uhm, W. S., Kim, S., & Bae, S. C. (2005). Cross-cultural adaptation and validation of the Korean version of the EQ-5D in patients with rheumatic diseases. Quality of Life Research, 14(5), 1401–1406. PubMedCrossRef

26.

Chon, K. K., Choi, S. C., & Yang, B. C. (2001). Integrated adaptation of CES-D in Korea. Korean Journal of Health Psychology, 6, 59–76.

27.

Lee, Y.-K., Nam, H.-S., Chuang, L.-H., Kim, K.-Y., Yang, H.-K., Kwon, I.-S., Kind, P., Kweon, S.-S., & Kim, Y.-T. (2009). South Korean time trade-off values for EQ-5D health states: Modeling with observed values for 101 health states. Value in Health, 12(8), 1187–1193.PubMedCrossRef

28.

Jacobson, A. M., Braffett, B. H., Cleary, P. A., Dunn, R. L., Larkin, M. E., Wessells, H., Sarma, A. V., & Group, D. E. R. (2015). Relationship of urologic complications with health-related quality of life and perceived value of health in men and women with type 1 diabetes: The Diabetes Control and Complications Trial/Epidemiology of Interventions and Complications (DCCT/EDIC) cohort. Diabetes Care, 38(10), 1904–1912.PubMedPubMedCentralCrossRef

29.

Park, S. S., Yoon, Y. S., & Oh, S. W. (2011). Health-related quality of life in metabolic syndrome: The Korea National Health and Nutrition Examination Survey 2005. Diabetes Research and Clinical Practice, 91(3), 381–388.PubMedCrossRef

30.

Weissman, M. M., Sholomskas, D., Pottenger, M., Prusoff, B. A., & Locke, B. Z. (1977). Assessing depressive symptoms in five psychiatric populations: A validation study. American Journal of Epidemiology, 106(3), 203–214.PubMedCrossRef

31.

Ranganathan, P., Pramesh, C., & Aggarwal, R. (2017). Common pitfalls in statistical analysis: Logistic regression. Perspectives in Clinical Research, 8(3), 148.PubMedPubMedCentral

32.

Ariza-Ariza, R., Hernandez-Cruz, B., & Navarro-Sarabia, F. (2003). Physical function and health-related quality of life of Spanish patients with ankylosing spondylitis. Arthritis and Rheumatism, 49(4), 483–487.PubMedCrossRef

33.

Dagfinrud, H., Mengshoel, A. M., Hagen, K. B., Loge, J. H., & Kvien, T. K. (2004). Health status of patients with ankylosing spondylitis: A comparison with the general population. Annals of the Rheumatic Diseases, 63(12), 1605–1610.PubMedPubMedCentralCrossRef

34.

Davis, J. C., van der Heijde, D., Dougados, M., & Woolley, J. M. (2005). Reductions in health-related quality of life in patients with ankylosing spondylitis and improvements with etanercept therapy. Arthritis and Rheumatism, 53(4), 494–501.PubMedCrossRef

35.

Zhao, S., Thong, D., Miller, N., Duffield, S. J., Hughes, D. M., Chadwick, L., & Goodson, N. J. (2018). The prevalence of depression in axial spondyloarthritis and its association with disease activity: A systematic review and meta-analysis. Arthritis Research & Therapy, 20(1), 140.CrossRef

36.

Kim, Y. (2014). The Korea National Health and nutrition examination survey (KNHANES): Current status and challenges. Epidemiology and Health, 36, e2014002. PubMedPubMedCentralCrossRef

37.

Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. (2017). Korea Health Statistics 2016: Korea National Health and Nutrition Examination Survey (KNHANES VII-1). 135.

38.

Webers, C., Essers, I., Ramiro, S., Stolwijk, C., Landewe, R., van der Heijde, D., van den Bosch, F., Dougados, M., & van Tubergen, A. (2016). Gender-attributable differences in outcome of ankylosing spondylitis: Long-term results from the Outcome in Ankylosing Spondylitis International Study. Rheumatology (Oxford), 55(3), 419–428.

39.

Rosenbaum, J. T., Pisenti, L., Park, Y., & Howard, R. A. (2019). Insight into the quality of life of patients with ankylosing spondylitis: Real-world data from a US-based life impact survey. Rheumatology and Therapy, 6(3), 353–367.PubMedPubMedCentralCrossRef

40.

Meesters, J. J., Bremander, A., Bergman, S., Petersson, I. F., Turkiewicz, A., & Englund, M. (2014). The risk for depression in patients with ankylosing spondylitis: A population-based cohort study. Arthritis Research & Therapy, 16(5), 418.CrossRef

41.

Park, J.-S., Jang, H.-D., Hong, J.-Y., Park, Y.-S., Han, K., Suh, S.-W., Park, S.-Y., & Kim, B.-T. (2019). Impact of ankylosing spondylitis on depression: A nationwide cohort study. Scientific Reports, 9(1), 1–6.

42.

Piccinelli, M., & Wilkinson, G. (2000). Gender differences in depression. Critical review. British Journal of Psychiatry, 177, 486–492.CrossRef

43.

Brionez, T. F., Assassi, S., Reveille, J. D., Green, C., Learch, T., Diekman, L., Ward, M. M., Davis, J. C., Jr., Weisman, M. H., & Nicassio, P. (2010). Psychological correlates of self-reported disease activity in ankylosing spondylitis. Journal of Rheumatology, 37(4), 829–834.CrossRefPubMed

44.

Durmus, D., Sarisoy, G., Alayli, G., Kesmen, H., Cetin, E., Bilgici, A., Kuru, O., & Unal, M. (2015). Psychiatric symptoms in ankylosing spondylitis: Their relationship with disease activity, functional capacity, pain and fatigue. Comprehensive Psychiatry, 62, 170–177.PubMedCrossRef

45.

Martindale, J., Smith, J., Sutton, C. J., Grennan, D., Goodacre, L., & Goodacre, J. A. (2006). Disease and psychological status in ankylosing spondylitis. Rheumatology (Oxford), 45(10), 1288–1293.CrossRef

46.

Baysal, O., Durmus, B., Ersoy, Y., Altay, Z., Senel, K., Nas, K., Ugur, M., Kaya, A., Gur, A., Erdal, A., Ardicoglu, O., Tekeoglu, I., Cevik, R., Yildirim, K., Kamanli, A., Sarac, A. J., Karatay, S., & Ozgocmen, S. (2011). Relationship between psychological status and disease activity and quality of life in ankylosing spondylitis. Rheumatology International, 31(6), 795–800.PubMedCrossRef

47.

Meesters, J. J., Petersson, I. F., Bergman, S., Haglund, E., Jacobsson, L. T., & Bremander, A. (2014). Sociodemographic and disease-related factors are associated with patient-reported anxiety and depression in spondyloarthritis patients in the Swedish SpAScania cohort. Clinical Rheumatology, 33(11), 1649–1656.PubMedCrossRef

48.

Godfrin-Valnet, M., Prati, C., Puyraveau, M., Toussirot, E., Letho-Gyselink, H., & Wendling, D. (2013). Evaluation of spondylarthritis activity by patients and physicians: ASDAS, BASDAI, PASS, and flares in 200 patients. Joint, Bone, Spine, 80(4), 393–398.CrossRef

49.

Redeker, I., Hoffmann, F., Callhoff, J., Haibel, H., Sieper, J., Zink, A., & Poddubnyy, D. (2018). Determinants of psychological well-being in axial spondyloarthritis: An analysis based on linked claims and patient-reported survey data. Annals of the Rheumatic Diseases, 77(7), 1017–1024.PubMedCrossRef

50.

Brionez, T. F., Assassi, S., Reveille, J. D., Learch, T. J., Diekman, L., Ward, M. M., Davis, J. C., Jr., Weisman, M. H., & Nicassio, P. (2009). Psychological correlates of self-reported functional limitation in patients with ankylosing spondylitis. Arthritis Research & Therapy, 11(6), R182.CrossRef

51.

Hakkou, J., Rostom, S., Aissaoui, N., Berrada, K. R., Abouqal, R., Bahiri, R., & Hajjaj-Hassouni, N. (2011). Psychological status in Moroccan patients with ankylosing spondylitis and its relationships with disease parameters and quality of life. Journal of Clinical Rheumatology, 17(8), 424–428.PubMedCrossRef

52.

Meesters, J., Bergman, S., Haglund, E., Jacobsson, L., Petersson, I. F., & Bremander, A. (2018). Prognostic factors for change in self-reported anxiety and depression in spondyloarthritis patients: Data from the population-based SpAScania cohort from southern Sweden. Scandinavian Journal of Rheumatology, 47(3), 185–193.PubMedCrossRef

53.

Webers, C., Vanhoof, L., Leue, C., Boonen, A., & Kohler, S. (2019). Depression in ankylosing spondylitis and the role of disease-related and contextual factors: A cross-sectional study. Arthritis Research & Therapy, 21(1), 215.CrossRef

54.

Zou, Q., Jiang, Y., Mu, F., Shi, Y., & Fang, Y. (2016). Correlation of axial spondyloarthritis with anxiety and depression. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 22, 3202.CrossRef

55.

Zhao, S., Jones, G. T., Macfarlane, G. J., Hughes, D. M., Dean, L. E., Moots, R. J., & Goodson, N. J. (2019). Associations between smoking and extra-axial manifestations and disease severity in axial spondyloarthritis: Results from the BSR Biologics Register for Ankylosing Spondylitis (BSRBR-AS). Rheumatology, 58(5), 811–819.PubMedCrossRef

56.

Chorus, A., Boonen, A., Miedema, H., & Van der Linden, S. (2002). Employment perspectives of patients with ankylosing spondylitis. Annals of the Rheumatic Diseases, 61(8), 693–699.PubMedPubMedCentralCrossRef

57.

Linn, M. W., Sandifer, R., & Stein, S. (1985). Effects of unemployment on mental and physical health. American Journal of Public Health, 75(5), 502–506.PubMedPubMedCentralCrossRef

58.

Whooley, M. A., Kiefe, C. I., Chesney, M. A., Markovitz, J. H., Matthews, K., & Hulley, S. B. (2002). Depressive symptoms, unemployment, and loss of income: The CARDIA Study. Archives of Internal Medicine, 162(22), 2614–2620.PubMedCrossRef

59.

Bulloch, A. G., Williams, J. V., Lavorato, D. H., & Patten, S. B. (2009). The relationship between major depression and marital disruption is bidirectional. Depression and Anxiety, 26(12), 1172–1177.PubMedCrossRef

60.

Taylor, A. E., Fluharty, M. E., Bjørngaard, J. H., Gabrielsen, M. E., Skorpen, F., Marioni, R. E., Campbell, A., Engmann, J., Mirza, S. S., & Loukola, A. (2014). Investigating the possible causal association of smoking with depression and anxiety using Mendelian randomisation meta-analysis: The CARTA consortium. British Medical Journal Open, 4(10), e006141.

61.

Villaverde-García, V., Cobo-Ibáñez, T., Candelas-Rodríguez, G., Seoane-Mato, D., del Campo-Fontecha, P. D., Guerra, M., Muñoz-Fernández, S., & Cañete, J. D. (2017). The effect of smoking on clinical and structural damage in patients with axial spondyloarthritis: A systematic literature review. Paper presented at the Seminars in arthritis and rheumatism.

62.

Cho, H., Kim, T., Kim, T.-H., Lee, S., & Lee, K. H. (2013). Spinal mobility, vertebral squaring, pulmonary function, pain, fatigue, and quality of life in patients with ankylosing spondylitis. Annals of Rehabilitation Medicine, 37(5), 675.PubMedPubMedCentralCrossRef

63.

Machado, P., Landewe, R., Braun, J., Hermann, K. G., Baraliakos, X., Baker, D., Hsu, B., & van der Heijde, D. (2011). A stratified model for health outcomes in ankylosing spondylitis. Annals of the Rheumatic Diseases, 70(10), 1758–1764.PubMedCrossRef

64.

Essers, I., Ramiro, S., Stolwijk, C., Blaauw, M., Landewe, R., van der Heijde, D., Van den Bosch, F., Dougados, M., & van Tubergen, A. (2016). Do extra-articular manifestations influence outcome in ankylosing spondylitis?: 12-year results from OASIS. Clinical and Experimental Rheumatology, 34(2), 214–221.PubMed

65.

Lopez-Medina, C., Garrido-Castro, J. L., Castro-Jimenez, J., Gonzalez-Navas, C., Calvo-Gutierrez, J., Castro-Villegas, M. C., Ortega-Castro, R., Escudero-Contreras, A., Font-Ugalde, P., & Collantes-Estevez, E. (2018). Evaluation of quality of life in patients with axial spondyloarthritis and its association with disease activity, functionality, mobility, and structural damage. Clinical Rheumatology, 37(6), 1581–1588.PubMedCrossRef

66.

Büssing, A., Ostermann, T., Neugebauer, E. A., & Heusser, P. (2010). Adaptive coping strategies in patients with chronic pain conditions and their interpretation of disease. BMC Public Health, 10(1), 507.PubMedPubMedCentralCrossRef

Titel: Gender differences in factors associated with low quality of life and depression in Korean patients with ankylosing spondylitis
verfasst von: Bora Nam
Bon San Koo
Seoung Wan Nam
Ji-Hui Shin
Yoonah Song
Soo-Kyung Cho
Yoon-Kyoung Sung
Tae-Hwan Kim
Publikationsdatum: 10.03.2021
Verlag: Springer International Publishing
Erschienen in: Quality of Life Research / Ausgabe 8/2021
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-021-02800-w

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Gender differences in factors associated with low quality of life and depression in Korean patients with ankylosing spondylitis

Abstract

Purpose

Methods

Results

Conclusion

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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