Missing pebble in the mosaic of rheumatic diseases and mental health: younger does not always mean happier

We have read with great interest the article by Redeker et al 1 investigating the determinants of psychological well-being in axial spondyloarthritis (SpA). The authors observed that among 1736 patients aged 18–79 years, 68% of subjects displayed depressive symptoms, ranging from mild to severe according to the five-item WHO Well-Being Index. This article clearly points out the burden of depressive symptoms in patients with SpA and its correlation with disease activity, functional impairment and other parameters including younger age. The authors emphasise that a potential explanation for the negative association between depressive symptoms and age might be a better capability to cope with the disease of adult compared with young patients. This aspect prompted our reflections, as the psychological impact of rheumatic and musculoskeletal diseases (RMDs) in young people is a major unmet need.We previously reported that over 90% of young patients with RMDs outline an impact of their condition on mental health which, …