Transtornos psiquiátricos em pacientes com Espondiloartrites atendidos no Hospital Universitário/Universidade Federal de Mato Grosso do Sul, Campo Grande/Mato Grosso do Sul∕ Brasil

Abstract

BACKGROUND: Spondyloarthritis(SpA) comprises a heterogeneous group of disorders that share genetic and clinical traits, as well as structural changes on imaging examination. The condition also has emotional consequences, affecting different aspects of the social life of patients. OBJECTIVE: To evaluate the occurrence of psychiatric disorders (PD) in patients with Spondyloarthritis seen at Teaching of the Hospital of the Universidade Federal de Mato Grosso do Sul (NHU- UFMS) in Campo Grande/MS. MATERIAL AND METHOD: A cross-sectional study of a non-random sample of 62 SpA and 140 non-SpA patients. The Adult Psychiatric Morbidity Questionnaire (QMPA) was administered to all patients, and cut-off was defined as seven or more affirmative responses. Next, the patients were clinically evaluated by a psychiatrist, according to the text-revised fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-R). Categorical and numerical variables were analyzed using Pearson's correlation for categorical data and Wilcoxon test for numerical data. RESULTS: Mean age of patients was 31.3 years. Males predominated (74.2%), with low instructional level (53.2%) and low household income. Most had no formal jobs (72.6%). Mean duration of Spondyloarthritis progression was 5.4 year. The diagnosis Ankylosing Spondylitis (n=43) patients (69.4% of total), and 36 (80.0%) were male and 7(41.2%) females, and among them, PD showed in 28(65.1%). The second most frequent clinical form of PsA, was Psoriatic Spondyloarthritis (n=12), 7 female and 5 male and, among them, PD showed in 11(91.7%). Then, there were Reactive PsA (n=5), 3(6.7%) were male and 2(11.8%) were female and, among them, PD showed in 2 (40.%). Then are presented PsA undifferentiated (n=1) female (5.9%) representing 100% of PD. Finally, Inflammatory Bowel Disease (n=1) were found, male, representing 100% of PD. Among SpA patients, the proportion of Psychiatric Disorders was higher among those with PSPA. The mean score obtained from the Survey of Psychiatric Morbidity in adults diagnosed with PsA was 12.5 in 79% of SpA group. While the non- SpA group 35% achieved a mean of 6.0 points. 91.7% of the 62 patients had indicating that this instrument is useful for screening study populations, but not for depression or anxiety, or a combination of both. In Non-SpA group, positive QMPA results were close to those found in populations without specific pathologies. Higher QMPA scores confirmed an association between pain and Psychiatric Disorders, either with causal link or concomitance. Upon psychiatric evaluation, 64.5% of patients with Spondyloarthritis (n=62) were diagnosed with some type of Psychiatric Disorders in disagreement with the results obtained using the QMPA (79%), individual diagnosis. CONCLUSIONS: Spondyloarthritis was more prevalent among males (72.6%) and at a mean age of 41 years. 53,2% of patients had low instructional level and 66,0% had low household income. In 31.3% of these patients, mean duration of Spondyloarthritis progression was 5.4 years. Positive QMPA results were found for 79% of SpA and 35% of non-SpA patients. The instrument proved useful for population screening, but not for individual diagnosis. Depression and depression plus anxiety were most frequent than anxiety alone. Considering all types of Spondyloarthritis, Psychiatric Disorders were proportionally higher (91%) among Psoriatic Spondyloarthritis patients.