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Positive and negative affective states and disease activity in ankylosing spondylitis

  • Original Article - Observational Research
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Abstract

The aim of the study was to explore the influence of psychological affective states such as cheerfulness and bad mood on self-reported disease activity in patients with ankylosing spondylitis (AS) while controlling for demographic and clinical variables. Patients attending a biological therapy unit were selected for a cross-sectional study if they met the criteria for AS and were already receiving treatment. Their psychological affective state was assessed with the state version of the State-Trait Cheerfulness Inventory. Clinical variables included were patient-reported disease activity using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and acute-phase reactants. We performed univariate and multivariate analyses to verify the robustness of the relationship between psychological affective states and disease activity. We also explored whether disease activity, measured either by self-report or by acute-phase reactants, was influenced by patient’s overall affective state. In the recruited 31 patients with AS, overall affective state contributed significantly to the variance in BASDAI scores, adding 21.8 % to the overall R-square of the predictive power of clinical and demographic variables (combined R-square = 17 %). A higher positive affective state was associated with lower values of C-reactive protein (p < 0.05). Results of a bootstrapping procedure showed that the relationship between C-reactive protein levels and BASDAI scores was mediated by overall affective state. In patients with AS, affective state can induce variability in self-reported disease activity. Patients’ overall affective state can explain the relationship between acute-phase reactants and self-reported scores. These findings suggest interesting possibilities for the monitoring of disease activity in AS.

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Acknowledgments

We would like to thank the patients of the Biological Therapy Unit of the Rheumatology Service of Reina Sofía Hospital in Cordoba, Spain, for their participation in this study as well as all the nurses who cooperated in this research.

Conflict of interest

None of the authors have any conflict of interests or financial interests to report regarding this manuscript.

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Authors and Affiliations

  1. Department of Medicine, University of Cordoba, Cordoba, Spain

    Carlos Jesús Delgado Domínguez

  2. Rheumatology Unit, Reina Sofía University Hospital, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, University of Cordoba, Cordoba, Spain

    Pilar Font Ugalde, Desireé Ruiz Vilchez & Eduardo Collantes Estévez

  3. Deparment of Methodology of Behavioral Sciences, University of Granada, Campus de Cartuja, 18071, Granada, Spain

    Hugo Carretero-Dios

Authors
  1. Carlos Jesús Delgado Domínguez
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  2. Pilar Font Ugalde
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  3. Desireé Ruiz Vilchez
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  4. Hugo Carretero-Dios
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  5. Eduardo Collantes Estévez
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Corresponding author

Correspondence to Hugo Carretero-Dios.

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Domínguez, C.J.D., Ugalde, P.F., Vilchez, D.R. et al. Positive and negative affective states and disease activity in ankylosing spondylitis. Rheumatol Int 35, 519–524 (2015). https://doi.org/10.1007/s00296-014-3107-y

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  • DOI: https://doi.org/10.1007/s00296-014-3107-y

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