CLINICAL FEATURES OF ANKYLOSING SPONDYLITIS COMORBID WITH ALEXITHYMIA

Vasylets V.V., Stanislavchuk M.A.

• National Pirogov Memorial Medical University, Vinnytsya

Summary. Studying the relationship between alexithymia and clinical and phenomenological features, quality of life, and psychosocial functioning is important for improving treatment and diagnostic approaches in ankylosing spondylitis. The aim: to establish the characteristics of clinical manifestations, quality of life and psychoemotional response of patients with ankylosing spondylitis with comorbid alexithymia. Materials and methods. 127 patients with ankylosing spondylitis were clinically examined: 62 with no alexithymia, 29 with possible alexithymia, and 36 with alexithymia. Results. Signs of pronounced alexithymia were detected in 28.3% of patients with AS, individual manifestations of alexithymia — in 22.8%. A significant deterioration was found with increasing manifestations of alexithymia in the indicators of clinical activity of AS BASDAI (in patients without alexithymia 4.80±1.86 points, in patients with a possible alexithymia 5.87±1.77 points, and in patients with alexithymia 6.91±1.83 points); ASDAS-ESR (respectively 3.22±0.91 points, 3.59±0.89 points and 3.94±0.79 points); indicators of functional disorders BASMI (respectively 3.27±1.48 points, 4.00±1.63 points and 5.22±2.07 points); BASFI (4.42±2.31 points, 5.56±1.75 points and 6.39±1.87 points); BAS-G (7 days) (5.61±2.15 points, 6.69±1.93 points and 7.42±1.65 points, respectively); health indicators ASAS HI (7.21±3.15 points, 8.93±2.34 points and 10.58±3.66 points, respectively); ASAS EF (2.76±1.36 points, 3.59±1.24 points and 4.08±1.36 points, respectively), HAQ (0.87±0.59 points, 1.28±0.59 points and 1.57±0.57 points, respectively); severity of pain syndrome according to VAS (5.90±1.87 points, 7.00±1.51 points and 7.78±1.15 points, respectively); quality of life indicator ASQoL (9.03±4.36 points, 10.86±2.76 points and 12.72±3.46 points, respectively). In patients without alexithymia, signs of mild depression according to HAM-D (10.02±6.79 points) were detected, in patients with possible alexithymia — depression of mild and moderate severity (13.62±8.72 points), in patients with alexithymia — depression of moderate severity (18.17±9.50 points). A high prevalence of moderate and severe dyssomnias in AS patients (PSQI score 7.48±3.90 points, 9.14±4.41 points and 12.36±3.91 points, respectively) and chronic fatigue (MAF score 25.16±11.04 points, 31.48±10.07 points and 36.86±7.77 points, respectively) was found. Significant (p<0.01) positive correlations of moderate strength were found between the TAS-20 score and the ESR, BASDAI, ASDAS-ESR, BASMI, BASFI, BAS-G, ASAS, HAQ, VAS pain, ASQoL, MAF, PSQI and HAM-D. Conclusions. Patients with AS have a high prevalence of alexithymia, which is associated with worse indicators of AS clinical activity, functional impairment and health status, and greater severity of psychopathological disorders.