- The prevalence of depression in patients with axial spondyloarthritis (axSpA) runs at 15%.
- Depression is associated with more severe disease activity and greater functional impairment.
Why this matters
- Treatment of depression has the potential to diminish axSpA disease activity and ameliorate functional impairment.
- Meta-analysis of 15 studies and 1 abstract (n=4753 patients with axSpA) that met eligibility criteria after search of Medline, PubMed, Web of Science, PsycINFO, CINAHL Plus, Cochrane Library, and conference abstracts.
- Funding: None disclosed.
- AxSpA had a pooled prevalence of 15% with at least moderate depression, using Hospital Anxiety and Depression Scale.
- Similar prevalence was seen in ankylosing spondylitis (AS) and nonradiographic axSpA.
- Comorbid depression was associated with worse disease activity than control group:
- higher Bath AS Disease Activity Index (by 1.4 units; 95% CI, 1.0-1.9);
- higher AS Disease Activity Score (by 0.05 units; 95% CI, 0.3-0.7); and
- higher erythrocyte sedimentation rate (by 3.5 mm/hour; 95% CI, 0.6-6.4).
- Comorbid depression was associated with greater functional impairment than control group:
- higher Bath AS Functional Index (by 1.2 units; 95% CI, 0.6-1.8);
- higher Bath AS Metrology Index (by 0.6 units; 95% CI, 0.3-0.8).
- Almost all studies used screening criteria to identify depression, possibly resulting in overestimation of prevalence.