Ankylosing spondylitis (AS) is one of the most common inflammatory rheumatisms. It is a chronic, sometimes disabling and it could cause both physical and psychological problems among patients, including depression.

With this in mind, the objective of our work was to study the prevalence of depression among patients with AS and to determine its associated factors.

This was a retrospective descriptive and analytical study, carried out in 2021 over a period of 5 years in southern Tunisia on patients with a confirmed diagnosis of AS established in accordance with the ASAS diagnostic criteria (Assessment of Spondyloarthritis International Society) or the modified New York criteria for AS. Depression was assessed using the Hospital anxiety and Depression (HAD) score. A HAD score>10 means certain depression.

A total of 62 patients were included in our study. The median age was 39 years with an interquartile range (IQR) = [32-50 years]. There were 35 men (56.5%). Inflammatory back pain was noted among 51 patients (82.3%). Extraarticular manifestations were noted among 14 cases (22.6%) and were mainly ocular (11 cases; 78.4%). The diagnosis was confirmed by ASAS criteria in 55 cases (88.7%). AS was treated symptomatically in 58 cases (93.5%), specifically by basic treatment among 17 patients (27.4%) and by additional physical rehabilitation among 15 patients (24.2%). Depression was certain among 30 patients, giving a global prevalence of 48.4%. The factors statistically associated with this disease among patients with AS were having a low level of education (illiterate or primary) (Odds Ratio (OR) = 2.87; p = 0.044), being clinically suffering from severe fatigue (OR= 7.14; p<0.001), have a poor quality of life [Ankylosing spondylitis quality of life questionnaire (Asqol) Score ≥13] (OR=4.52; p=0.007) and have certain anxiety (HAD>10) (OR=19; p<0.001).

In addition to its clinical impact on patients, the psychological impact of AS was considerable in terms of depression. The factors associated with it were individual, clinical, and psychological. Thus, psychological support must be coupled with AS medical management in order to prevent psychological disorders among patients, particularly depression.

None Declared

Ankylosing spondylitis (AS) is the second most common rheumatic disease after rheumatoid arthritis. The significant functional impact of this chronic disease can affect patients’ mental health.

The aim of this study was to determine the prevalence of anxiety in subjects with AS in Southern-Tunisia and to identify its associated factors.

It was a retrospective study conducted in 2021 over a period of 5 years on patients with AS consulting the rheumatology department at the Hedi Chaker University Hospital in SFAX, Southern-Tunisia. The “Anxiety and Depression scale” was used to screen for anxiety. A score ≥11 defined confirmed anxiety symptoms.

Of the 62 patients, 35 were male (56.5%), giving a male to female ratio of 1.3. Twenty-seven patients (43.5%) were aged between 35 and 50 years. The level of education was primary in 19 cases (30.6%) and university in 15 cases (24.2%). A family history of chronic disease was present in 32 cases (51.6%). Severe fatigue was noted among 27 patients (43.5%). Quality of life was poor in 39 patients (62.9%). The mean anxiety score was 11.35±4.6. Thirty-four subjects (54.8%) had confirmed anxiety symptoms and 19 (30.5%) had borderline symptoms. Confirmed anxiety was significantly associated with the educational level (p=0.03) (illiterate: 87.5%, primary: 68.4%, secondary: 35% and university: 46.7%). Similarly, having a family history of chronic disease (OR=3.3; p=0.02), suffering from severe fatigue (OR=36, p<0.01), having associated depression (HAD score≥11) (OR=19.5; p<0.001) and having poor quality of life [Ankylosing spondylitis quality of life questionnaire (Asqol) Score ≥13] (OR=15.8; p<0.001) were statistically associated with higher prevalence of confirmed anxiety symptoms.

It was found that patients treated for AS frequently suffer from psychological co-morbidities, particularly anxiety, which can lead to a further deterioration in their quality of life and even their withdrawal from active life. Thus, anxiety should not be ignored when treating these patients.

None Declared

Psychological diffusing takes place within the first hours after a trauma. At first, authors had hope it would be an efficient way to prevent post traumatic stress disorder (PTSD) but it is now considered as an ineffective intervention by many authors. Although, studies showed it could be more effective in military populations compared with civilian populations.

Objectives and aims

To evaluate the effects of defusing after a trauma in a military population.

Patients and Methods

A group of 5 active military soldiers who faced a mine explosion were included. They were referred to the emergency room in military hospital in Tunis with various benign lesions on the first day of trauma. A psychological diffusing was performed by psychiatrists from the psychiatry ward on this very first day. These patients were evaluated one month after in order to screen for PTSD.

All participants were male, aged 23 to 29. All patients met criteria for acute stress disorder on the first day. After one month, all 5 patients reported a significant subjective improving of their symptoms. Screening for PTSD was performed using the CAPS and found that 2 over 5 patients met criteria for PTSD. All 5 patients had residual symptoms. All patients were put on medications and a cognitive behavioral therapy is planned for them.

Psychological diffusing can sometimes be an effective intervention in military populations. Further research is needed with larger populations.