Mental health in patients with rheumatoid arthritis and axial spondyloarthritis: a cross-sectional, case–control tertiary centre study from Czechia

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023752%3A_____%2F25%3A43921628" target="_blank" >RIV/00023752:_____/25:43921628 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11110/25:10506912 RIV/00216208:11120/25:43929233 RIV/00023728:_____/25:N0000050

Result on the web

<a href="https://bmjopen.bmj.com/content/15/12/e103686" target="_blank" >https://bmjopen.bmj.com/content/15/12/e103686</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1136/bmjopen-2025-103686" target="_blank" >10.1136/bmjopen-2025-103686</a>

Result language

angličtina

Original language name

Mental health in patients with rheumatoid arthritis and axial spondyloarthritis: a cross-sectional, case–control tertiary centre study from Czechia

Original language description

Objectives To evaluate the mental health burden in rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) using diagnostic and self-reported tools and to examine its associations with current disease activity, patient-reported outcomes and barriers to appropriate care. Design Single-centre, cross-sectional, case-control study. Setting Rheumatology centre of a tertiary care hospital, serving as a referral clinic with outpatient and inpatient care in Czech Republic. Participants 233 patients with rheumatic diseases (113 RA, 120 axSpA) and 170 healthy controls (HC). Outcome measures Mental disorders (MD) were assessed through a structured psychiatric interview using the International Neuropsychiatric Interview (Mini International Neuropsychiatric Interview) administered by a trained professional and by self-reported questionnaires including the Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI). Disease activity was evaluated with the Disease Activity Score-28 with C-reactive protein (DAS28-CRP) for RA and the Ankylosing Spondylitis Disease Activity Score with CRP (ASDAS-CRP) for axSpA, alongside patient-reported outcomes (PROs).Results At least one MD was present in 24.8% of RA, 31.7% of axSpA and 7.0% of HC (p&lt;0.001), driven mainly by major depression, dysthymia and suicidal ideation. Thresholds for depression and anxiety were significantly more frequent in RA and axSpA than HC (BDI-II: 18.6% vs 4.0% and 17.5% vs 1.7%; BAI: 38.9% vs 13.9% and 26.7% vs 11.0%; all p&lt;0.001). Patients with MD had higher disease activity (RA: DAS28-CRP 3.12 vs 2.68, p&lt;0.05; axSpA: ASDAS-CRP 2.39 vs 1.63, p&lt;0.001). The presence of MD was associated with an increase of 0.40 in DAS28-CRP and 0.24 in ASDAS-CRP, although a 10-point increase in BDI-II was required for a similar association. Most patients with MD (75.0% RA, 89.6% axSpA) declined psychiatric counselling despite poorer concurrent outcomes in disease activity and PROs. Conclusions Mental disorders in RA and axSpA are closely associated with higher disease activity and unfavourable PROs, while access to and acceptance of psychiatric care remain markedly insufficient. Systematic integration of mental health assessment and management into rheumatology practice is strongly warranted.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30218 - General and internal medicine

Project

<a href="/en/project/NU21-09-00297" target="_blank" >NU21-09-00297: Concurrence of the rheumatic and psychiatric diseases: epidemiology, identification of the risk-group population and economic costs</a><br>

Continuities

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Publication year

2025

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

BMJ Open

ISSN

2044-6055

e-ISSN

2044-6055

Volume of the periodical

15

Issue of the periodical within the volume

12

Country of publishing house

GB - UNITED KINGDOM

Number of pages

12

Pages from-to

"e103686"

UT code for WoS article

001637956400001

EID of the result in the Scopus database

2-s2.0-105024588019