OBJECTIVES Although cross-sectional studies have shown that ankylosing spondylitis-specific factors correlate with depressive symptom severity, the association of these factors over time is unresolved. We examined the demographic and clinical factors associated with longitudinal depressive symptom severity in AS patients. METHODS We analyzed sociodemographic, clinical, behavioral and medication data from 991 patients from the Prospective Study of Outcomes in Ankylosing spondylitis cohort, and measured depression severity with the Center for Epidemiological Studies Depression (CES-D) Scale administered at approximately 6-month visit intervals. Multivariable longitudinal negative binomial regression models were conducted using generalized estimating equation modeling to assess the demographic, clinical, and medication-related factors associated with depression severity by CES-D scores over time. RESULTS The median baseline CES-D score (possible range 0-60) was 10.0 (interquartile range = 5, 17). In longitudinal multivariable analyses, higher CES-D scores were associated with longitudinal smoking, greater functional impairment, greater disease activity, self-reported depression, and poor global health scores. Marital status (e.g., being married) was associated with lower CES-D. Adjusted mean CES-D scores in our model decreased over time, with a significant interaction between time and gender observed. CONCLUSION This study identified longitudinal clinical factors such as greater disease activity, greater functional impairment, and poor global health to be associated with longitudinal depression severity. These factors are potentially modifiable and may help manage depressive symptoms in AS.

中文翻译：

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强直性脊柱炎患者抑郁症状与临床因素之间的纵向关联：来自观察性队列的分析。

目的尽管横断面研究表明强直性脊柱炎特异性因子与抑郁症状的严重程度相关，但这些因子与时间的相关性尚未得到解决。我们检查了AS患者中与纵向抑郁症状严重程度相关的人口统计学和临床​​因素。方法我们分析了强直性脊柱炎队列前瞻性研究的991例患者的社会人口统计学，临床，行为和用药数据，并采用流行病学研究中心的抑郁症（CES-D）量表以大约6个月的访视间隔进行了抑郁测量。使用广义估计方程模型进行了多变量纵向负二项式回归模型，以评估人口统计学，临床，随时间推移的CES-D评分与抑郁症严重程度相关的药物相关因素。结果CES-D基线中位数（可能范围0-60）为10.0（四分位间距= 5、17）。在纵向多变量分析中，较高的CES-D评分与纵向吸烟，更大的功能障碍，更大的疾病活动，自我报告的抑郁症以及较差的整体健康评分有关。婚姻状况（例如，已婚）与较低的CES-D有关。在我们的模型中，调整后的CES-D平均得分随着时间的推移而下降，并且观察到的时间和性别之间存在显着的相互作用。结论本研究确定了纵向临床因素，如更大的疾病活动性，更大的功能障碍和较差的整体健康状况，与纵向抑郁症的严重程度有关。