E138 Assessing depression levels of patients with axial spondyloarthritis using the PHQ-9 to assess locality and gender differences

Abstract Background/Aims The prevalence of depression in people with spondyloarthritis is thought to be higher than in the general population. It is estimated that 40% of patients will have mild depression, with up to 15% of people suffering from moderate/severe depression. Routinely assessing patients’ depression levels has only recently started in this Trust. The Trust covers a large geographical area with contrasting socio-economic populations. The aims of the audit were firstly to see if there were any differences between patients who lived in the coastal area compared to those inland, and secondly, to assess if there were any differences in depression levels with gender. Methods All patients attending the physio-led inflammatory back pain clinic in the York and Scarborough Hospitals are routinely asked to complete disease activity questionnaires when waiting for their clinic appointment. Between May 2024 and April 2025, patients were also invited to complete the Patient Health Questionnaire-9 (PHQ-9), which assesses depression. In patients who scored 15 or above, which is classed as moderately severe or severe, the clinician discussed the score and how the patient felt about their mental health. Results 242 patients completed the PHQ-9. 66% of patients were male and 39% of patients lived at the coast. In all groups of patients, the percentage of patients not having depression was very similar, ranging from 42-48%. Females were more likely to have mild depression, whether they lived coastally or inland (30% and 32%, respectively) compared to males (19% and 20%, respectively). Females, however, were less likely to have moderate-severe (23.6 %) than males (35%); again, there was little variation between those who lived inland or at the coast. The biggest difference was seen in patients with a PHQ-9 of over 20, indicating severe depression; this was much higher in males at the coast (12%), compared to more internally living females (4%). Conclusion The overall results from all patients across the Trust showed lower levels of mild depression (25%), but higher levels of moderate/severe depression (29%) compared to other studies. This was irrespective of where patients lived. Females had less depression, which again contrasts other research into quality of life in axial spondyloarthritis, suggesting that females often have worse outcomes. Formally assessing depression has been a valuable addition to the patient consultation, adding to the holistic care of patients. In patients with higher depression scores, the clinician discussed the potential reasons for the depression and was able to direct patients to the appropriate service to address their needs. Depression is now routinely assessed and addressed in the clinic. A further audit of follow-up scores of patients would be helpful to show if the interventions had been beneficial. Disclosure H. Harrison: None.