OBJECTIVES: To examine the impact of ankylosing spondylitis (AS) on patients 
across the UK and to identify factors associated with unemployment, absenteeism, 
and presenteeism.
METHODS: One thousand patients with AS from 10 specialist rheumatology centres 
across the UK were invited to participate in a study evaluating a new outcome 
measure. Patients completed a questionnaire, which included questions relating 
to their work, sociodemographic and clinical characteristics.
RESULTS: The questionnaire was completed by 612 patients (438 males; 72%). The 
mean age of the participants was 50.8 (SD 12.2) years, mean disease duration was 
17.3 (SD 11.7) years, and mean symptom duration 22.4 (SD 12.4) years. A total of 
206 (40%) patients of working age were not employed. Factors associated with not 
being employed were social deprivation [odds ratio (OR) 3.52, 95% confidence 
interval (CI) 2.14-5.80], poor function (OR 3.42, 95% CI 1.90-6.13), depression 
(OR 2.05, 95% CI 1.12-3.78), increasing age (OR 1.05 per year, 95% CI 
1.02-1.08), and longer disease duration (OR 1.03 per year, 95% CI 1.01-1.06). 
Disease activity (OR 3.24, 95% CI 1.11-9.48) and depression (OR 3.22, 95% CI 
1.22-8.48) were associated with absenteeism, while depression (OR 5.69, 95% CI 
1.77-18.27, disease activity (OR 3.97, 95% CI 1.76-8.98), anxiety (OR 3.90, 95% 
CI 1.83-8.31), self-efficacy (OR 0.71, 95% CI 0.58-0.86), and increasing age (OR 
1.04 per year, 95% CI 1.00-1.08) were associated with presenteeism.
CONCLUSION: Psychological, sociodemographic, and disease-related factors were 
all found to be related to work status. These factors should be taken into 
account when considering early treatment and management. Depression, in 
particular, appears to be associated with employment, absenteeism, and 
presenteeism, and should therefore be prioritized in clinical practice.