The Effect of Axial Spondyloarthritis on Mental Health: Results from the Atlas.

OBJECTIVE: To assess the risk of mental disorders in patients with axial spondyloarthritis (axSpA) and to examine the factors associated with this. METHODS: In 2016, a sample of 680 patients with axSpA were interviewed as part of the development process for the Atlas of Axial Spondyloarthritis in Spain. The risk of mental disorders in these patients was assessed using the 12-item General Health Questionnaire scale. Additionally, the variables associated with the risk of mental disorders were investigated, including sociodemographic characteristics (age, sex, relationship, patient association membership, job status, and educational level), disease status (Bath Ankylosing Spondylitis Disease Activity Index, spinal stiffness, and functional limitation), and previous diagnosis of mental disorders (depression and anxiety). Bivariate correlation analyses were performed, followed by multiple hierarchical and stepwise regression analysis. RESULTS: A total of 45.6% patients were at risk of mental disorders. All variables except educational level and thoracic stiffness significantly correlated with risk of mental disorders. Nevertheless, disease activity, functional limitation, and age showed the highest coefficient (r = 0.543, p ≤ 0.001; r = 0.378, p ≤ 0.001; r = -0.174, p ≤ 0.001, respectively). In the stepwise regression analysis, 4 variables (disease activity, functional limitation, patient association membership, and cervical stiffness) explained the majority of the variance for the risk of mental disorders. Disease activity displayed the highest explanatory degree (R2 = 0.875, p < 0.001). CONCLUSION: In patients with axSpA, the prevalence of risk of mental disorders is high. Combined with a certain sociodemographic profile, high disease activity is a good indicator of the risk for mental disorders.

[Internal structure of Dysfunctional Beliefs and Attitudes about Sleep Scale in a Spanish shift workers sample]. / Estructura interna de la Dysfunctional Beliefs and Attitudes about Sleep Scale en una muestra espanola de trabajadores con turnos rotatorios.

INTRODUCTION: Dysfunctional beliefs are some of the psychological factors that explains the origin and maintenance of insomnia. Morin developed a five theoretical dimension scale, the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS), to assess them. AIMS: To analyze the internal structure of the Spanish version of DBAS, and to establish the differences on DBAS scores between two groups above described. SUBJECTS AND METHODS: The sample was 237 workers of those 197 were shift workers and the rest had a stable timetable (mean age = 43.07; standard deviation = 9.39). The DBAS and the Pittsburgh Sleep Quality Index was administrated to them. RESULTS: The results of the items analysis and reliability of each five dimensions were moderate, except for the first and second dimension of Morin's proposal. Confirmatory factorial analysis isolated four factors: consequences of the insomnia on the diurnal yield/functioning (alpha = 0.75); control and prediction of the sleep (alpha = 0.70); consequences of the insomnia on the physical and mental health (alpha = 0.69), and expectations on the association sleep-age (alpha = 0.60). It was corroborated that either first, second or third factor allowed differentiating one group of another. CONCLUSIONS: All these results allowed us to consider Spanish version of DBAS as an appropriated 18 items adapted version. The structure of four factors is theoretically coherent, and it shows an adequate internal consistency and high capacity to differentiate well from bad sleepers.

Estructura interna de la Dysfunctional Beliefs and Attitudes about Sleep Scale en una muestra española de trabajadores con turnos rotatorios / Internal structure of Dysfunctional Beliefs and Attitudes about Sleep Scale in a spanish shift workers sample

Introducción. Uno de los factores psicológicos que explicanel origen y mantenimiento del insomnio son los pensamientosdisfuncionales incompatibles con la conciliación del sueño. Paraevaluarlos, Morin elaboró la escala de creencias y actitudes sobreel sueño –Dysfunctional Beliefs and Attitudes about Sleep Scale(DBAS)– integrada por cinco dimensiones teóricas. Objetivos. Analizarla estructura interna de la versión española de la DBAS en unamuestra de trabajadores con turnos rotatorios y determinar su capacidadpara diferenciar a estos sujetos de los que tienen un horariolaboral normal. Sujetos y métodos. A una muestra de 237 trabajadores,197 con horario laboral rotatorio y 40 con horario normal(media de edad = 43,07; desviación típica = 9,39) se le aplicó laDBAS y el índice de calidad de sueño de Pittsburgh. Resultados. Elanálisis de ítems y de la fiabilidad de cada una de las cinco dimensionesoriginales de la DBAS pone de manifiesto los valores moderadosde las correlaciones ítem-total, así como la falta de homogeneidad,a excepción de la primera y segunda dimensión. El análisisfactorial exploratorio permite aislar cuatro factores: consecuenciasdel insomnio sobre el rendimiento/funcionamiento diurno (alfa =0,75); control y predicción del sueño (alfa = 0,70); consecuenciasdel insomnio sobre la salud física y mental (alfa = 0,69) y expectativassobre la asociación sueño-edad (alfa = 0,60); asimismo, se demuestraque los tres primeros diferencian a trabajadores con turnosrotatorios de trabajadores con horario laboral normal. Conclusiones.Se obtiene una versión adaptada de la DBAS formada por 18ítems distribuidos en cuatro factores coherentes conceptualmente,que muestran unos índices aceptables de consistencia interna; lostres primeros manifiestan capacidad para diferenciar a buenos demalos dormidores

Introduction. Dysfunctional beliefs are some of the psychological factors that explains the origin and maintenanceof insomnia. Morin developed a five theoretical dimension scale, the Dysfunctional Beliefs and Attitudes about Sleep Scale(DBAS), to assess them. Aims. To analyze the internal structure of the Spanish version of DBAS, and to establish thedifferences on DBAS scores between two groups above described. Subjects and methods. The sample was 237 workers of those197 were shift workers and the rest had a stable timetable (mean age = 43.07; standar deviation = 9.39). The DBAS and thePittsburgh Sleep Quality Index was administrated to them. Results. The results of the items analysis and reliability of each fivedimensions were moderate, except for the first and second dimension of Morin’s proposal. Confirmatory factorial analysisisolated four factors: consequences of the insomnia on the diurnal yield/functioning (alpha = 0.75); control and prediction ofthe sleep (alpha = 0.70); consequences of the insomnia on the physical and mental health (alpha = 0.69), and expectations onthe association sleep-age (alpha = 0.60). It was corroborated that either first, second or third factor allowed differentiatingone group of another. Conclusions. All these results allowed us to consider Spanish version of DBAS as an appropriated 18items adapted version. The structure of four factors is theoretically coherent, and it shows an adequate internal consistencyand high capacity to differentiate well from bad sleepers