When disease activity is high and/or function impaired, consider depression a likely comorbidity that may be a result of inflammation.
Reference1. Zhao S, Thong D, Miller N, et al. The prevalence of depression in axial spondyloarthritis and its association with disease activity: a systematic review and meta-analysis. Arthritis Res Ther. 2018;20:140. doi: 10.1186/s13075-018-1644-6.