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Clinical Rheumatology

, Volume 34, Issue 3, pp 503–510 | Cite as

The relationship between disease activity measured by the BASDAI and psychological status, stressful life events, and sleep quality in ankylosing spondylitis

  • Yutong Jiang
  • Mingcan Yang
  • Husheng Wu
  • Hui Song
  • Feng Zhan
  • Shengyun Liu
  • Guanmin Gao
  • Zhangsuo Liu
  • Zhaoxian Hu
  • Peigen He
  • Shengtao Zhang
  • Zaiying Hu
  • Zhiming Lin
  • Yanli Zhang
  • Yinong Li
  • Lingxun Shen
  • Anbing Huang
  • Zetao Liao
  • Shuangyan Cao
  • Yanlin Wei
  • Li Li
  • Qiuxia Li
  • Qing Lv
  • Jun Qi
  • Jianlin Huang
  • Tianwang Li
  • O. Jin
  • Yunfeng Pan
  • J. GuEmail author
Original Article

Abstract

Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is a standard instrument regularly used to assess disease activity of patients with ankylosing spondylitis (AS). However, the well-being of a patient is also affected by impairment of function as well as psychological status and other factors. The objective of this study was to evaluate if psychological status, stressful life events, and sleep quality contribute significantly to BASDAI. Six hundred eighty-three AS patients satisfying the Modified New York Criteria for AS were recruited from the rheumatology clinics of seven hospitals in China. Patients with other concomitant disorders were excluded. Participants were requested to complete a set of clinical examinations and the following questionnaires: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Zung Self-Rating Anxiety Scale (SAS), Zung Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index Questionnaire (PSQI), Health Assessment Questionnaire for Spondyloarthropathies (HAQ-S), and Social Readjustment Rating Scale (SRRS). Spearman correlation analysis showed that BASDAI was highly associated with degree and duration of morning stiffness, overall pain, nocturnal back pain, overall back pain, anxiety, and BASFI (all P < 0.001), but were not associated with education, HAQ-S, and sleep medication in PSQI (P > 0.05). Multiple stepwise regression analysis indicated that overall pain was the maximal statistical contribution in predicting disease activity (standardized coefficient, 0.335). In hierarchic multiple regression analysis, psychological variables added an only additional 2.7 % to the overall R 2 beyond that accounted for by demographic and medical variables, resulting in a final R 2 of 53.5 %. Although BASDAI is a very good measurement of pain and stiffness and to a certain extent effect of functional impairment in AS, it barely takes into account psychological status, stress life events, and sleep quality These factors should be evaluated by other modalities.

Keywords

Ankylosing spondylitis Anxiety BASDAI Depression Psychological disorder Sleep disturbance Stressful life events 

Notes

Acknowledgments

This project was supported by the National Natural Sciences Foundation of China (31070806), Clinical Subject (2007 and 2010) of Ministry of Public Health of China and from the Foundation of Guangdong province of China (2005A30801005 and 2008B080701086), State Board of Education Fund for the Doctoral (20060558046), Guangzhou Science and Technology Plan Projects (2006Z2-E0221), and 5010 Subject of Sun Yat-sen University (2009–2010).

Disclosures

None.

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Copyright information

© Clinical Rheumatology 2014

Authors and Affiliations

  • Yutong Jiang
    • 1
  • Mingcan Yang
    • 1
  • Husheng Wu
    • 2
  • Hui Song
    • 2
  • Feng Zhan
    • 3
  • Shengyun Liu
    • 4
  • Guanmin Gao
    • 4
  • Zhangsuo Liu
    • 4
  • Zhaoxian Hu
    • 5
  • Peigen He
    • 5
  • Shengtao Zhang
    • 5
  • Zaiying Hu
    • 1
  • Zhiming Lin
    • 1
  • Yanli Zhang
    • 1
  • Yinong Li
    • 6
  • Lingxun Shen
    • 7
  • Anbing Huang
    • 7
  • Zetao Liao
    • 1
  • Shuangyan Cao
    • 1
  • Yanlin Wei
    • 1
  • Li Li
    • 1
  • Qiuxia Li
    • 1
  • Qing Lv
    • 1
  • Jun Qi
    • 1
  • Jianlin Huang
    • 1
  • Tianwang Li
    • 1
  • O. Jin
    • 1
  • Yunfeng Pan
    • 1
  • J. Gu
    • 1
    Email author
  1. 1.Department of Rheumatology and ImmunologyThe Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina
  2. 2.Department of Rheumatology and ImmunologyBeijing Jishuitan HospitalBeijingChina
  3. 3.Department of RheumatologyHainan Provincial People’s HospitalHaikouChina
  4. 4.Department of Urology and RheumatologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
  5. 5.Department of Immunology and Rheumatology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  6. 6.Department of RheumatologyFuzhou General Hospital of Nanjing Military CommandFuzhouChina
  7. 7.Department of Immunology and Rheumatology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina

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