Determinants of self-reported health status in ankylosing spondylitis.

Abstract

To assess the relative contributions of disability related variables, personality traits and social network characteristics to self-reported general health status in ankylosing spondylitis (AS). For 144 patients with AS (modified New York criteria; 112 men) the following variables were assessed cross sectionally: disability related variables (age, duration of disease, spinal mobility, physicians' global assessment), personality traits (neuroticism, social inadequacy, self-esteem, health locus of control) and loneliness. Health status was assessed by means of 3 self-administered instruments: Sickness Impact Profile, Health Assessment Questionnaire for the Spondyloarthropathies and Self-assessed Function. Factor analysis of the 3 health status instruments suggested one underlying health status score. This derived health status score correlated significantly with each of the disability related variables, the personality traits and loneliness (p < 0.05), but not with social inadequacy and physician oriented health control. In multiple regression analysis 4 variables contributed significantly, together explaining 44% of the total variance of the derived health status score: neuroticism 25%, physicians' global assessment 8%, internal oriented health control 6% and spinal mobility 5% (p < 0.001). In AS, self-reported health status is more strongly related to personality traits than to the degree of disability. When assessing health status in AS by self-report, personality traits must be taken into account.