ArticleBMJ open2025
Mental health in patients with rheumatoid arthritis and axial spondyloarthritis: a cross-sectional, case-control tertiary centre study from Czechia.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Association of inflammation and serum adipocytokines with depression and anxiety burden in axial spondyloarthritis.Scientific reports · 2026Article
- Impact Of A Structured Emotional Well-Being Workshop On Psychological Outcomes And Patient Activation In Rheumatoid Arthritis And Spondyloarthritis: A Pilot Study.Journal of multidisciplinary healthcare · 2026Article
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8 authors.
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Abstract
objectivesTo 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.
designSingle-centre, cross-sectional, case-control study.
settingRheumatology centre of a tertiary care hospital, serving as a referral clinic with outpatient and inpatient care in Czech Republic.
participants233 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).
resultsAt least one MD was present in 24.8% of RA, 31.7% of axSpA and 7.0% of HC (p<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<0.001). Patients with MD had higher disease activity (RA: DAS28-CRP 3.12 vs 2.68, p<0.05; axSpA: ASDAS-CRP 2.39 vs 1.63, p<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.
conclusionsMental 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.
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