Psychiatric aspects of spondyloarthritis

Abstract

Spondyloarthritis refers to immune-mediated inflammatory rheumatic diseases characterized by the most pronounced pain, inflammatory activity and disability of patients of working age. One of the most frequent comorbid to spondy-loarthritis diseases that weigh down the course and outcomes are anxiety-depressive spectrum disorders. Chronic inflammation with hyperproduction of cytokines of the interleukin-23/interleukin-17 axis and violation of intracellular signaling of these cytokines, developing against the background of a violation of the stress and immune response, is a key pathogenetic mechanism that combines spondyloarthritis and anxiety-depressive spectrum disorders, and dictates approaches to their therapy. The article discusses the current understanding of the prevalence of mental disorders among patients with spondyloarthritis and their negative impact on the course and outcomes of the rheumatic disease, the common pathogenesis and provoking factors, the influence of antidepressants on spondyloarthritis outcomes and anti-inflammatory drugs, primarily interleukin-17 inhibitors and tumor necrosis factor alpha inhibitors on the symptoms of anxiety-depressive spectrum disorders.

Keywords

• spondyloarthritis
• ankylosing spondylitis
• psoriatic arthritis
• mental disorders
• depression
• suicides
• antidepressants
• interleukin-17 inhibitors