Work Instability Linked to Fatigue, Depression in Ankylosing Spondylitis

Work Instability Linked to Fatigue, Depression in Ankylosing Spondylitis


In patients with ankylosing spondylitis (AS), fatigue and symptoms of depression are associated with work instability, which creates a significant economic burden, according to the results of a case-control study published in Clinical Rheumatology.

The investigators sought to explore the association between work instability and fatigue, depression, and anxiety in working patients with AS compared with healthy controls. A total of 61 working patients with AS (aged 19 to 57 years) and 40 gender- and age-matched working healthy controls (aged 21 to 61 years) were enrolled in the study. Participants were evaluated with respect to age, educational level, type of work (sedentary or manual), time at job, medical comorbidities, and smoking habits. Disease duration, family history, current medications, and laboratory findings, including erythrocyte sedimentation rate and C-reactive protein, were also reported.

Data were obtained using the visual analog scale (VAS) for pain, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index, and Bath AS Metrology Index in patients with AS, along with Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Multidimensional Assessment of Fatigue (MAF), and AS Work Instability Scale (ASWIS) in all participants.

Fatigue, depression, and work instability scores (MAF, BDI, and ASWIS) were all significantly higher in patients with AS compared with healthy controls (<.001, =.004, and <.001, respectively). Moreover, strong positive correlations were demonstrated between ASWIS scores and BDI, BASDAI, and MAF scores (<.001). ASWIS scores were also moderately associated with VAS, BAI, and BASFI (<.001).

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Madelaine A. Feldman, MD, FACR

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