Pos1589-hpr high disease activity has a negative effect on pain catastrophizing, fear avoidance and body awareness levels in patients with ankylosing spondylitis- a preliminary study

Background Ankylosing spondylitis (AS) is a rheumatic disease that affects patients in a biopsychosocial framework due to its chronic inflammatory nature. It is known that patients with AS experience negative body judgment and insecurity and anxiety about their bodies [1], high levels of fear of movement, depression [2], low level of physical activity [3]. Objectives The aim of this study was to investigate the effects of disease activity (DA) on depression, physical activity, pain catastrophizing, fear avoidance, and body awareness in patients with ankylosing spondylitis. Methods Thirty AS patients were included in the study. Socio-demographic informations of patients were collected. The mean age of the patients was 40.27 ± 10.38 years. Beck Depression Inventory (BDI), International Physical Activity Questionnaire-Short Form (IPAQ-SF), Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK), and Body Awareness Questionnaire (BAQ) were used for depression, physical activity, pain catastrophizing, kinesiophobia and body awareness levels of the patients, respectively. DA was measured with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and a score of four and higher than four was considered active. Results Patients characteristics were similar between the groups (p>0.05). A statistically significant difference was observed in PCS (p= 0.004), TSK (p=0.007), and BAQ scores (p=0.015) when the groups were compared (Table 1). The patients in the low DA group had mild depression, and the group with high DA had moderate depression. Catastrophizing pain and fear of movement were higher in the group with higher DA; body awareness level was lower (p<0.05). A high kinesiophobia level was detected in both groups. Conclusion It was observed that high disease activity negatively affected catastrophic thoughts, body awareness, and kinesiophobia in patients with AS. These parameters should be considered in the management of disease activity in AS patients for optimum results. References [1]Guenther, V., et al., Body image in patients with ankylosing spondylitis. Clin Exp Rheumatol, 2010. 28 (3): p. 341-7. [2]Oskay, D., et al., Relationship between kinesiophobia and pain, quality of life, functional status, disease activity, mobility, and depression in patients with ankylosing spondylitis. Turkish journal of medical sciences, 2017. 47 (5): p. 1340-1347. [3]O’Dwyer, T., F. O’Shea, and F. Wilson, Physical activity in spondyloarthritis: a systematic review. Rheumatology international, 2015. 35 (3): p. 393-404. Table 1. Patients characteristics and outcome measures Patients Characteristics Total n=30 High Disease Activity n= 18 Low Disease Activity n= 12 p-value * Age (year): mean ± SD 40.27 ± 10.38 39.39 ± 9.41 41.58 ± 12.0 0.518 BMI (kg/m 2 ): mean ± SD 26.66 ± 5.78 27.00 ± 6.92 26.16 ± 3.81 0.790 Gender (n, %) Female 7 (23.3%) 5 2 0.632 Male 23 (76.7%) 13 10 Duration of disease (year): mean ± SD 5.91 ± 7.28 4.77 ± 6.54 7.56 ± 8.36 0.556 CRP (mg/dl) 5.2 (0.60-49.06) 5 (0.70-49.06) 5.6 (0.60-23.40) 0.884 ESR (mm/h) 9 (3-54) 10 (3-54) 7.5 (3-21) 0.811 BASDAI (0-10) 5.2 (1.40-8.90) 6.75 (4.0-8.90) 3.05 (1.40-3.85) 0.000 Outcome Measures BDI (0-63) 14 (0-42) 18 (6-42) 13.5 (0-24) 0.107 IPAQ-SF 1188 (66-5805) 1287 (198-5805) 1089 (66-4158) 0.450 PCS (0-52) 27 (7-50) 35.5 (7-50) 17 (10-30) 0.004 TSK (0-68) 42.5 (25-57) 44.5 (34-57) 39 (25-47) 0.007 BAQ (18-126) 91.5 (49-120) 80 (49-118) 108 (83-120) 0.015 Values are medians (minimum-maximum) unless otherwise stated. AS= Ankylosing spondylitis; SD= Standard deviation; BMI= Body mass index; m= meter; kg= kilogram; CRP= C reactive protein; ESR= Erythrocyte sedimentation rate; BDI= Beck Depression Inventory; IPAQ-SF= International Physical Activity Questionnaire-Short Form; PCS= Pain Catastrophizing Scale; TSK= Tampa Scale for Kinesiophobia; BAQ= Body Awareness Questionnaire. * = Mann-Whitney U test. Acknowledgements: NIL. Disclosure of Interests None Declared.