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Research ArticleArticle

The Effect of Axial Spondyloarthritis on Mental Health: Results from the Atlas

Marco Garrido-Cumbrera, C.J. Delgado-Domínguez, D. Gálvez-Ruiz, C. Blanch Mur and V. Navarro-Compán for the Atlas Working Group
The Journal of Rheumatology February 2019, jrheum.180868; DOI: https://doi.org/10.3899/jrheum.180868
Marco Garrido-Cumbrera
From Health & Territory Research of the Universidad de Sevilla, Seville; Spanish Federation of Spondyloarthritis Associations (CEADE), Madrid; Novartis, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain. This study was funded by Novartis, Spain. Atlas 2017 is an initiative of CEADE, carried out by the Health & Territory Research of the Universidad de Sevilla and the Max Weber Institute, with the collaboration of the Spanish Society of Rheumatology and sponsored by Novartis, Spain. M. Garrido-Cumbrera, PhD, Health & Territory Research of the Universidad de Sevilla, and CEADE; C.J. Delgado-Domínguez, PhD, Health & Territory Research of the Universidad de Sevilla; D. Gálvez- Ruiz, PhD, Health & Territory Research of the Universidad de Sevilla; C. Blanch Mur, PhD, Novartis, Spain; V. Navarro-Compán, MD, PhD, IdiPAZ. Address correspondence to Prof. M. Garrido-Cumbrera, Health & Territory Research (HTR), Centro de Investigación, Tecnología e Innovación Manuel Losada Villasante, Universidad de Sevilla, C/ Dr. Rafael Martínez Domínguez, s/n. Seville 41013, Spain. E-mail: mcumbrera@us.es. Accepted for publication January 25, 2019.
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C.J. Delgado-Domínguez
From Health & Territory Research of the Universidad de Sevilla, Seville; Spanish Federation of Spondyloarthritis Associations (CEADE), Madrid; Novartis, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain. This study was funded by Novartis, Spain. Atlas 2017 is an initiative of CEADE, carried out by the Health & Territory Research of the Universidad de Sevilla and the Max Weber Institute, with the collaboration of the Spanish Society of Rheumatology and sponsored by Novartis, Spain. M. Garrido-Cumbrera, PhD, Health & Territory Research of the Universidad de Sevilla, and CEADE; C.J. Delgado-Domínguez, PhD, Health & Territory Research of the Universidad de Sevilla; D. Gálvez- Ruiz, PhD, Health & Territory Research of the Universidad de Sevilla; C. Blanch Mur, PhD, Novartis, Spain; V. Navarro-Compán, MD, PhD, IdiPAZ. Address correspondence to Prof. M. Garrido-Cumbrera, Health & Territory Research (HTR), Centro de Investigación, Tecnología e Innovación Manuel Losada Villasante, Universidad de Sevilla, C/ Dr. Rafael Martínez Domínguez, s/n. Seville 41013, Spain. E-mail: mcumbrera@us.es. Accepted for publication January 25, 2019.
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  • ORCID record for C.J. Delgado-Domínguez
D. Gálvez-Ruiz
From Health & Territory Research of the Universidad de Sevilla, Seville; Spanish Federation of Spondyloarthritis Associations (CEADE), Madrid; Novartis, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain. This study was funded by Novartis, Spain. Atlas 2017 is an initiative of CEADE, carried out by the Health & Territory Research of the Universidad de Sevilla and the Max Weber Institute, with the collaboration of the Spanish Society of Rheumatology and sponsored by Novartis, Spain. M. Garrido-Cumbrera, PhD, Health & Territory Research of the Universidad de Sevilla, and CEADE; C.J. Delgado-Domínguez, PhD, Health & Territory Research of the Universidad de Sevilla; D. Gálvez- Ruiz, PhD, Health & Territory Research of the Universidad de Sevilla; C. Blanch Mur, PhD, Novartis, Spain; V. Navarro-Compán, MD, PhD, IdiPAZ. Address correspondence to Prof. M. Garrido-Cumbrera, Health & Territory Research (HTR), Centro de Investigación, Tecnología e Innovación Manuel Losada Villasante, Universidad de Sevilla, C/ Dr. Rafael Martínez Domínguez, s/n. Seville 41013, Spain. E-mail: mcumbrera@us.es. Accepted for publication January 25, 2019.
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C. Blanch Mur
From Health & Territory Research of the Universidad de Sevilla, Seville; Spanish Federation of Spondyloarthritis Associations (CEADE), Madrid; Novartis, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain. This study was funded by Novartis, Spain. Atlas 2017 is an initiative of CEADE, carried out by the Health & Territory Research of the Universidad de Sevilla and the Max Weber Institute, with the collaboration of the Spanish Society of Rheumatology and sponsored by Novartis, Spain. M. Garrido-Cumbrera, PhD, Health & Territory Research of the Universidad de Sevilla, and CEADE; C.J. Delgado-Domínguez, PhD, Health & Territory Research of the Universidad de Sevilla; D. Gálvez- Ruiz, PhD, Health & Territory Research of the Universidad de Sevilla; C. Blanch Mur, PhD, Novartis, Spain; V. Navarro-Compán, MD, PhD, IdiPAZ. Address correspondence to Prof. M. Garrido-Cumbrera, Health & Territory Research (HTR), Centro de Investigación, Tecnología e Innovación Manuel Losada Villasante, Universidad de Sevilla, C/ Dr. Rafael Martínez Domínguez, s/n. Seville 41013, Spain. E-mail: mcumbrera@us.es. Accepted for publication January 25, 2019.
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V. Navarro-Compán
From Health & Territory Research of the Universidad de Sevilla, Seville; Spanish Federation of Spondyloarthritis Associations (CEADE), Madrid; Novartis, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain. This study was funded by Novartis, Spain. Atlas 2017 is an initiative of CEADE, carried out by the Health & Territory Research of the Universidad de Sevilla and the Max Weber Institute, with the collaboration of the Spanish Society of Rheumatology and sponsored by Novartis, Spain. M. Garrido-Cumbrera, PhD, Health & Territory Research of the Universidad de Sevilla, and CEADE; C.J. Delgado-Domínguez, PhD, Health & Territory Research of the Universidad de Sevilla; D. Gálvez- Ruiz, PhD, Health & Territory Research of the Universidad de Sevilla; C. Blanch Mur, PhD, Novartis, Spain; V. Navarro-Compán, MD, PhD, IdiPAZ. Address correspondence to Prof. M. Garrido-Cumbrera, Health & Territory Research (HTR), Centro de Investigación, Tecnología e Innovación Manuel Losada Villasante, Universidad de Sevilla, C/ Dr. Rafael Martínez Domínguez, s/n. Seville 41013, Spain. E-mail: mcumbrera@us.es. Accepted for publication January 25, 2019.
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Abstract

Objective To assess the risk of mental disorders in patients with axial spondyloarthritis (axSpA) and to examine the factors associated with this.

Methods In 2016, a sample of 680 patients with axSpA were interviewed as part of the development process for the Atlas of Axial Spondyloarthritis in Spain. The risk of mental disorders in these patients was assessed using the 12-item General Health Questionnaire scale. Additionally, the variables associated with the risk of mental disorders were investigated, including sociodemographic characteristics (age, sex, relationship, patient association membership, job status, and educational level), disease status (Bath Ankylosing Spondylitis Disease Activity Index, spinal stiffness, and functional limitation), and previous diagnosis of mental disorders (depression and anxiety). Bivariate correlation analyses were performed, followed by multiple hierarchical and stepwise regression analysis.

Results A total of 45.6% patients were at risk of mental disorders. All variables except educational level and thoracic stiffness significantly correlated with risk of mental disorders. Nevertheless, disease activity, functional limitation, and age showed the highest coefficient (r = 0.543, p ≤ 0.001; r = 0.378, p ≤ 0.001; r = –0.174, p ≤ 0.001, respectively). In the stepwise regression analysis, 4 variables (disease activity, functional limitation, patient association membership, and cervical stiffness) explained the majority of the variance for the risk of mental disorders. Disease activity displayed the highest explanatory degree (R2 = 0.875, p < 0.001).

Conclusion In patients with axSpA, the prevalence of risk of mental disorders is high. Combined with a certain sociodemographic profile, high disease activity is a good indicator of the risk for mental disorders.

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Vol. 46, Issue 12
1 Dec 2019
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The Effect of Axial Spondyloarthritis on Mental Health: Results from the Atlas
Marco Garrido-Cumbrera, C.J. Delgado-Domínguez, D. Gálvez-Ruiz, C. Blanch Mur, V. Navarro-Compán
The Journal of Rheumatology Feb 2019, jrheum.180868; DOI: 10.3899/jrheum.180868

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The Effect of Axial Spondyloarthritis on Mental Health: Results from the Atlas
Marco Garrido-Cumbrera, C.J. Delgado-Domínguez, D. Gálvez-Ruiz, C. Blanch Mur, V. Navarro-Compán
The Journal of Rheumatology Feb 2019, jrheum.180868; DOI: 10.3899/jrheum.180868
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