7/27/2016

Medline Abstracts for References 43-45 of 'Clinical manifestations of ankylosing spondylitis in adults'
OfficialreprintfromUpToDate
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MedlineAbstractsforReferences4345
of'Clinicalmanifestationsofankylosingspondylitisinadults'

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PubMed
Sleepdisturbancesareassociatedwithincreasedpain,diseaseactivity,depression,andanxietyinankylosingspondylitis:acase
controlstudy.
LiY,ZhangS,ZhuJ,DuX,HuangF
ArthritisResTher.2012Oct14(5):R215.Epub2012Oct11.
ABSTRACT:INTRODUCTION:Literaturedatasuggestthatsleepdisturbancesareprevalentamongpatientswithankylosing
spondylitis(AS)andhaveaclosecorrelationwithpain.Otherstudiesindicatethatsleepdisturbancesareconstantlyaccompaniedby
depressionandanxietyinAS,buttheirinterrelationsarepoorlyunderstood.Thisstudywasdesignedtoevaluatesleepdisturbances
andtheirassociationwithdemographicvariables,pain,diseasespecificvariables,functionalstatus,coveringdepressionandanxiety
inASpatients.METHODS:The314patientswithASandageandsexmatchedcontrolstookpartinthestudy,completedabatteryof
questionnaires,andparticipatedinlongtermfollowup.BloodsamplesweretakentomeasureCreactiveprotein(CRP)andthe
erythrocytesedimentationrate(ESR).Theassociationamongsleep,pain,diseaseactivity,functionalstatus,depression,andanxiety
wereassessedbyusingPearson/Spearmancorrelationsandmultipleregressionanalysis.RESULTS:ThePittsburghSleepQuality
Index(PSQI)scoreoftheChineseversionwassignificantlyhigherintheASgroupthaninthecontrolgroup(P=0.020).Ofthe314
patientswithAS,184(58.6%)hadahighriskforsleepdisturbances.ThePSQIscorewasassociatedwithage,yearsofeducation,
ESR,CRP,overallassessmentofhealth,pain,morningstiffness,BathAnkylosingSpondylitisDiseaseActivityIndex(BASDAI),Bath
AnkylosingSpondylitisFunctionalIndex(BASFI),depression,andanxiety(allP<0.001),butwerenotassociatedwithdisease
duration,fingertiptofloordistance,andBathAnkylosingSpondylitisMetrologyIndex(BASMI)(P>0.05).Inhierarchicmultiple
regressionanalysis,themedicalandpsychologicalvariablescontributedsignificantlytothevarianceinsleepdisturbancesscores,
addinganadditional23.9%totheoverallR2beyondthataccountedforbydemographicvariables(Rsquare,8.5%),resultinginafinal
R2of42.6%.Multiplestepwiseregressionanalysisrevealedthatanxietywasthemaximalstatisticalcontributioninpredictingsleep
disturbances(standardizedcoefficients,0.287).CONCLUSIONS:TheprevalenceofsleepdisturbancesinASpatientsishigherthanit
isgenerallythoughttobe.Depression,anxiety,nocturnalpain,andtotalbackpainarethemajorcontributorsofsleepdisturbancesin
AS.

AD DepartmentofRheumatology,ChinesePLAGeneralHospital,28FuxingRoad,Beijing100853,China.fhuang1964@yahoo.com.
PMID23058191
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PubMed
Impactofankylosingspondylitisonworkandfamilylife:comparisonswiththeUSpopulation.
WardMM,ReveilleJD,LearchTJ,DavisJCJr,WeismanMH
ArthritisRheum.2008Apr59(4):497503.
OBJECTIVE:Toexaminetheimpactofankylosingspondylitis(AS)onworkdisability,nonparticipationinthelaborforce,marriage,
divorce,andchildbearing.
METHODS:Inthiscrosssectionalsurvey,weaskedASpatients(n=591,72.8%men,meanage48.9years)fromtheLosAngeles,
Houston,SanFrancisco,andWashington,DCmetropolitanareasaboutworkandfamilylife.Theproportionofpatientswhowere
workdisabled,didnotparticipateinthelaborforce,hadneverbeenmarried,weredivorced,orhadabiologicalchildwerecompared
withtheproportionsexpectedforeachoutcomebasedondatafrompopulationsurveys.
RESULTS:PatientswithASweremorelikelytobeworkdisabled(13.3%versus5.7%P<0.0001)andsomewhatmorelikelytonot
participateinthelaborforcecomparedwiththeproportionexpected(25.1%versus21.8%P=0.07).Theseassociationswere
strongeramongpatientsage>or=45yearsandthosewithASfor>or=20years.ASpatientsweremorelikelythanexpectedtohave
neverbeenmarried(22.8%versus15.4%P<0.0001)ortobedivorced(13.2%versus10.0%P=0.02).WomenwithASwereless
likelythanexpectedtohavehadchildren(54.7%versus64.9%P=0.02),buttheproportionofmenwithASwhohadchildrenwas
notdifferentfromthatofthegeneralpopulation.
CONCLUSION:PatientswithASinthisstudyweremorelikelytohaveneverbeenmarried,morelikelytobedivorced,andmorethan
twiceaslikelytobeworkdisabledthanmembersofthegeneralpopulation.WomenwithASwerealsolesslikelytohavehadchildren
thanwomeninthegeneralpopulation.

AD NationalInstituteofArthritisandMusculoskeletalandSkinDiseases,NIH,Bethesda,Maryland20892,USA.wardm1@mail.nih.gov
PMID18383414

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Psychologicalcorrelatesofselfreporteddiseaseactivityinankylosingspondylitis.
BrionezTF,AssassiS,ReveilleJD,GreenC,LearchT,DiekmanL,WardMM,DavisJCJr,WeismanMH,NicassioP
JRheumatol.2010Apr37(4):82934.Epub2010Feb15.

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Medline Abstracts for References 43-45 of 'Clinical manifestations of ankylosing spondylitis in adults'

OBJECTIVE:Toinvestigatetheroleofpsychologicalvariablesinselfreporteddiseaseactivityinpatientswithankylosingspondylitis
(AS),whilecontrollingfordemographicandmedicalvariables.
METHODS:PatientswithAS(n=294)meetingmodifiedNewYorkcriteriacompletedpsychologicalmeasuresevaluatingdepression,
resilience,activeandpassivecoping,internality,andhelplessness.Demographic,clinical,andradiologicdatawerealsocollected.
Univariateandmultivariateanalyseswerecompletedtodeterminethestrengthofthecorrelationofpsychologicalvariableswith
diseaseactivity,asmeasuredbytheBathASDiseaseActivityIndex(BASDAI).
RESULTS:Inthemultivariateregressionanalysis,thepsychologicalvariablescontributedsignificantlytothevarianceinBASDAI
scores,addinganadditional33%totheoverallRsquarebeyondthataccountedforbydemographicandmedicalvariables(combined
Rsquare18%).Specifically,arthritishelplessnessanddepressionaccountedforthemostsignificantportionofthevariancein
BASDAIscoresinthefinalmodel.
CONCLUSION:Arthritishelplessnessanddepressionaccountedforsignificantvariabilityinselfreporteddiseaseactivitybeyond
clinicalanddemographicvariablesinpatientswithAS.Thesefindingshaveimportantclinicalimplicationsinthetreatmentand
monitoringofdiseaseactivityinAS,andsuggestpotentialavenuesofintervention.

AD

DepartmentofMedicine,DivisionofRheumatology,UniversityofTexasHealthScienceCenteratHouston,Houston,Texas77030,
USA.
PMID20156952

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