Clinical Rheumatology

, Volume 38, Issue 4, pp 1017–1024 | Cite as

Association of work instability with fatigue and emotional status in patients with ankylosing spondylitis: comparison with healthy controls

  • Yasemin UlusEmail author
  • Yesim Akyol
  • Ayhan Bilgici
  • Omer Kuru
Original Article



Ankylosing spondylitis (AS) is usually seen in among younger person of working age and carries a significant economic burden. It was aimed to explore the relation of work instability with fatigue, depression, and anxiety in working AS patients comparing with healthy controls.


This case-control study was conducted on working 61 AS patients and 40 sex-age-matched working healthy controls. The data were collected using Visual analogue scale-pain, Bath AS Disease Activity Index, Bath AS Functional Index, Bath AS Metrology Index in patients; and Beck Depression Inventory, Beck Anxiety Inventory, Multidimensional Assessment of Fatigue, AS Work Instability Scale in all participants. Data were analyzed by SPSS, using chi-squared test, Mann–Whitney U test, Kruskal–Wallis test, Spearman correlation analysis, and multivariate linear regression analysis.


Depression, fatigue, and work instability scores were significantly higher in patients than controls (p < 0.05). Clinical parameters (except spinal mobility) showed a significant worsening across the levels of work instability in patients (p < 0.05) and work instability scores were positively correlated with all clinical parameters except spinal mobility (p < 0.001). There was a weak correlation between work instability and spinal mobility (p < 0.05). Fatigue (p < 0.001), pain, and functional capacity scores (p < 0.05) were found to be influential variables on work instability scores.


The results of this study demonstrated that fatigue and depressive symptoms had negative effect on work instability beside pain, disease activity, and functionality in patients with AS. The recognition and improvement of fatigue and depression may lead to reduced risk of job loss in these patients.


Ankylosing spondylitis Anxiety Depression Fatigue Work 



The authors would like to thank Yuksel Terzi (Professor, Department of Statistics, Faculty of Science and Arts, Ondokuz Mayis University) for his help with statistical analyses.

Author’s contributions

Yasemin Ulus: Design of the work, interpretation of data for the work, analysis of data, drafting the work, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Yesim Akyol: Contributions to the conception, interpretation of data for the work, revising the work critically for important intellectual content, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Ayhan Bilgici: Contributions to the conception, revising the work critically for important intellectual content, final approval of the version to be published.

Omer Kuru: Contributions to the conception, revising the work critically for important intellectual content, final approval of the version to be published.

Compliance with ethical standards




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2018

Authors and Affiliations

  1. 1.Department of Physical Medicine and Rehabilitation, Medical FacultyOndokuz Mayis UniversitySamsunTurkey

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