Risk of Psychiatric Comorbidity Higher in Patients With Ankylosing Spondylitis

Patients with ankylosing spondylitis (AS) are at increased risk for psychiatric disorders compared with age- and sex-matched controls, according to a study published in the Journal of Affective Disorders.

Researchers used medical and administrative data from Clalit Health Services, the largest health organization in Israel, to compare the prevalence of psychiatric disorders in 5825 patients with AS and 25,984 matched control patients without AS.

According to the study, 13.8% of patients with AS had psychiatric morbidity compared with 9.8% of patients without AS. The rate of major depression was higher in patients with AS; researchers reported an odds ratio of 1.60 compared with controls. Meanwhile, the rate of schizophrenia was lower in patients with AS. The odds ratio for schizophrenia in those with the AS was 0.60 compared with controls.

The use of conventional disease-modifying antirheumatic drugs and tumor necrosis factor inhibitors did not predict psychiatric disorders in patients with AS, the analysis found.

“Based on the reported finding, our cohort shows a significant association of psychiatric illnesses and AS,” wrote corresponding author Kassem Sharif, MD, of the Zabludowicz Center for Autoimmune Diseases at Sheba Medical Center in Tel Hashomer, and coauthors. “On closer investigation, patients with AS have a significantly increased prevalence of depression and a lower prevalence of schizophrenia, a result that remained significant even after correction for several relevant confounders including age, gender, country of birth, obesity, smoking, and other factors.”

Reference: 
Omar M, Ben-Shabat N, Tsur AM, et al. The association between ankylosing spondylitis and psychiatric disorders: Insights from a population based cross-sectional database. J Affect Disord. 2023;323:788-792. doi:10.1016/j.jad.2022.12.024