Postgraduate Researchers in Science Medicine Conference 2005: Abstracts
A Longitudinal Study of Clinical and Psychological Status in Ankylosing Spondylitis
Jane H Martindale, BA,Grad.Dip. Phys, Jane Smith, PhD,Cpsychol, Chris Sutton, PhD, C Stat , Azad A, David Swinson, M.D., F.R.C.P., David Grennan, M.D. F.R.C.P. and John A Goodacre, M.D. PhD
Background: Psychological factors may play an important role in the course and outcome of Ankylosing Spondylitis (AS) and also in clinical assessment and management of this condition. We repeatedly assessed a large group of AS patients who regularly attend a review group at Wrightington Hospital over two years in order to identify possible associations between clinical and psychological status in AS and to determine whether these were consistent over time.
Methods: 110 AS patients were assessed at 6-monthly intervals on up to four occasions using validated tools for clinical (BASMI, BASFI, BASDAI) and psychological status (HAD, HLC-C, SF-36). Data were stored and analysed in SPSS.
Results: 89 participants [74 males (mean age 48 years, range 18-77); 15 females (mean age 45 years, range 27-56)] completed all 4 assessments. Throughout the two years, BASMI, BASFI and BASDAI scores correlated consistently and significantly with anxiety, depression and internality scores, but not with levels of belief in chance or powerful others. Subgroups with clinical anxiety and/or depression had consistently worse disease activity and function, but not range of movement. Subgroups with low internality generally had worse clinical status, whilst age and co-existent psoriasis, but not disease duration or sex, also had a significant impact on some of the associations between clinical and psychological status.
Conclusions: Clinical status in AS correlated consistently with levels of anxiety, depression and internality over two years. However, patient subgroups could be identified for which the existence and strength of these associations differed markedly. These findings have important potential applications both in the assessment and management of AS patients.
Jane Martindale, Health, University of Central Lancashire, 2 Horridge Fold Ave, Over Hulton, Bolton, Lancashire
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