Depression More Common in People with Ankylosing Spondylitis, Analysis Shows

Depression is more common among people with ankylosing spondylitis (AS) than in the general population, with about a third of patients experiencing depressive symptoms, a meta-analysis reveals.

The study, “Prevalence of Depression in Ankylosing Spondylitis: A Systematic Review and Meta-Analysis,” was published in the journal Psychiatry Investigation.

The relationship between physical and mental health is complex and interconnected, with each having a real and measurable influence on the other. Consequently, it is of great interest to researchers to understand the prevalence of mental health problems among people with non-psychiatric illnesses so that the best possible patient-oriented healthcare can be provided.

Researchers combed through the published scientific literature to find studies assessing the prevalence and/or severity of depression among people with AS.

They identified 31 relevant studies, with information reported for 8,106 people with AS (75.9% male, average age 39.2 years). In individual studies, estimations of depression rate varied dramatically, from 3% to 66%. It is worth noting that 15 different depression assessments were used across the studies, which may explain some of this variability.

A pooled analysis incorporating all available data suggested an overall depression rate of 35% among people with AS.

Furthermore, eight of the studies directly compared rates of depression between people with and without AS; these studies suggest that people with AS are at a 76% higher risk of depression. Additionally, among the seven studies where depression scores were quantified, people with AS had higher average scores than those without.

Looking at the individual studies, the researchers noted that estimates of depression prevalence tended to be higher among small studies, studies published more recently, and studies done in developing countries.

The researchers did note a significant indication of publication bias among the studies. This term refers to the idea that more interesting or newsworthy results — say, “people with AS are more depressed” — are more likely to get published. Thus, these findings should be interpreted with appropriate caution, and more research is still needed.

“One-third of people with AS experienced symptoms of depression. Depression was more prevalent in AS patients than in controls. Further research is needed to identify effective strategies for preventing and treating depression among AS patients,” the researchers concluded.