Ankylosing Spondylitis Patients Face Greater Risk of Depression, Study Finds

Having ankylosing spondylitis more than doubles the risk of developing depression, and the presence of additional chronic conditions exacerbates this risk, a South Korean population-based study reports.

Older female patients and those with a low household income were also found to be more susceptible to depression.

These findings were reported in a study, “Impact of ankylosing spondylitis on depression: a nationwide cohort study,” published in the journal Scientific Reports.

Ankylosing spondylitis is characterized by pain, stiffness, and fatigue, symptoms that commonly appear early in life, usually before age 30. Patients often experience progressive physical deterioration that can affect their professional capacity and quality of life. Altogether, these manifestations contribute to an increased risk of developing additional mental issues such as depression.

These patients are also more susceptible to other chronic diseases, such as diabetes, and cardiovascular and cerebrovascular diseases, which may also increase their vulnerability to mental disorders.

Hence, when caring for these patients, “it is essential to determine any other existing chronic diseases and be aware of the risks of developing depression from such diseases,” researchers said.

To determine how often people with ankylosing spondylitis faced depression, and examine how that risk related to patient characteristics and other chronic diseases, researchers reviewed the clinical records of 11,465 newly diagnosed patients in South Korea. They also analyzed the records of 57,325 sex- and age-matched patients without the disease. All the data was collected from the Korean National Health Insurance System (KNHIS) from 2010 to 2014.

During this period, new cases of depression were diagnosed in 10.84% of ankylosing spondylitis patients, and in 5.05% cases in the group without the disease.

Taken into account several patient variables, including age, sex, household income, and comorbidities, researchers found that the risk of depression was of about 2.21 times higher in patients with ankylosing spondylitis than in the general population without the disease.

“Ankylosing spondylitis patients had greater risk of depression as the time progressed from the initial diagnosis,” researchers said. “In the fifth year following the initial diagnosis, 1.5 out of 10 ankylosing spondylitis patients and 0.5 out of 10 non-ankylosing spondylitis patients required the administration of antidepressant drugs.”

Additional analysis revealed that female patients, those older than 40, and those living in poorer economic conditions were the most likely to face depression, with 1.6, 1.8, and 1.3 times increased risk.

Chronic comorbidities, such as diabetes, high blood pressure, high blood fats, cancer, stroke, or chronic kidney disease, also worsened this vulnerability. In particular, those who experienced stroke and end-stage renal disease had the highest risk, twice as great as those who did not.

“This population-based cohort study showed that ankylosing spondylitis significantly increased the subsequent risk of developing depression,” researchers said. They suggested that doctors treating these patients “acknowledge the demographic characteristics, comorbidity, risk factors, and latent risk for depression” in order to achieve the best care.