Mental health and quality of life for people with rheumatoid arthritis or ankylosing spondylitis in Aotearoa New Zealand following the COVID-19 national lockdown

Abstract

The aim of this study was to investigate the effects of lockdown on the mental health (anxiety and depression) and quality of life (QOL) of people with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) in the context of the COVID-19 pandemic and public health measures instituted at a national level by the New Zealand Government. The present cohort was 104 individuals with RA (73.1%) and AS (26.9%) who had previously completed surveys for the Patient Opinion Real-Time Anonymous Liaison (PORTAL) project in 2018. Participants completed an online survey between July and September 2020 assessing their experiences over the first national COVID-19 lockdown in New Zealand (March-May, 2020). Fear of SARS-CoV-2 infection, baseline anxiety, and being younger in age were all predictors of participants' current anxiety levels. Current QOL scores were significantly lower than prior to lockdown and were predicted by baseline QOL and current depression. No variables predicted current depression other than baseline levels. The COVID-19 pandemic appears to have had an impact on QOL and anxiety levels, but not depression for people with RA and AS in New Zealand. These novel findings imply that appropriate screening of mental health issues should be included in planning within the ongoing COVID-19 pandemic and for future pandemics to optimise the wellbeing of people with RA and AS.

Minimal Impact of the COVID‐19 Pandemic on Disease Activity and Health‐Related Quality of Life in Patients With Ankylosing Spondylitis Receiving Bimekizumab: Exploratory Analyses From a Phase 2b Open‐Label Extension Study

“…Our findings differ from some real‐world studies evaluating the implications of the pandemic on patients with rheumatic disease, which may reflect the clinical trial setting of this study and differences in patient populations, study design approaches, and use of alternative outcome measures ( 4 , 6 , 7 , 9 , 10 ). For example, disease activity in this study population at the start of the pandemic was low overall and patients may have been less susceptible to pandemic‐related effects as a result.…”

“…Restrictions are also likely to have limited patients’ physical activity, potentially leading to poorer patient outcomes given that AS symptoms can be exacerbated by reduced exercise. Real‐world studies evaluating the implications of the pandemic on disease activity and HRQoL in patients with axSpA have found inconsistent results ( 4 , 5 , 6 , 7 , 8 , 9 , 10 ).…”

Interoceptive anxiety-related processes: Importance for understanding COVID-19 and future pandemic mental health and addictive behaviors and their comorbidity

“…In a cross-sectional study among 262 adults in Turkey, a direct link between COVID-19 fears and more severe symptoms of anxiety, depression, and PTSD symptoms was evident ( Kira et al, 2021 ). Johnstone et al (2021) also reported a significant relation between COVID-19 fear and more severe anxiety in a cross-sectional analysis of 104 individuals with rheumatoid arthritis and ankylosing spondylitis in New Zealand.…”

Addressing mental health issues in immunocompromised adolescents with chronic diseases during the COVID-19 pandemic

“…The effects of COVID-19 lockdown on mental health were more thoroughly examined in adult patients with various immunosuppressive diseases, and the published data consistently demonstrate a significant impact on anxiety levels and decreased quality of life. [13] , [14] , [15] One of the strongest identified predictors of increased anxiety was fear due to the perceived risk of more severe COVID-19 infection in immunocompromised individuals, which was linked with ongoing media reports highlighting a greater risk of severe outcomes in these patients. [13] On the other side, participation in different types of physical activity such as walking and exercise was positively associated with indicators of mental health and psychological wellbeing in adult patients with immunosuppressive diseases.…”

“… [13] , [14] , [15] One of the strongest identified predictors of increased anxiety was fear due to the perceived risk of more severe COVID-19 infection in immunocompromised individuals, which was linked with ongoing media reports highlighting a greater risk of severe outcomes in these patients. [13] On the other side, participation in different types of physical activity such as walking and exercise was positively associated with indicators of mental health and psychological wellbeing in adult patients with immunosuppressive diseases. [ 16 , 17 ] Although the detrimental effects of lockdown on mental health are well established also in the general adolescent population, [7] some data from recent studies suggest that these findings cannot be simply extrapolated to the at-risk adolescent population.…”