Clinical, Functional and Health-related Quality of Life Correlates of Clinically Significant Symptoms of Anxiety and Depression in Patients with Systemic Sclerosis: a Cross-sectional Survey

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2014 Mar 4

PMID 24587375

Citations 22

Authors

Christelle Nguyen

Brigitte Ranque

Thierry Baubet

Alice Berezne

Caroline Mestre-Stanislas

Francois Rannou

Agathe Papelard

Sandrine Morell-Dubois

Michel Revel

Marie-Rose Moro

Loic Guillevin

Serge Poiraudeau

Luc Mouthon

Affiliations

Soon will be listed here.

Abstract

Objectives: To identify clinical, functional and health-related quality of life (HRQoL) correlates of clinically significant symptoms of anxiety and depression in patients with systemic sclerosis (SSc).

Methods: Three-hundred-and-eighty-one patients fulfilling the American College of Rheumatology and/or the Leroy and Medsger criteria for SSc were assessed for visceral involvement, disability and HRQoL (assessed by SF-36). Clinically significant symptoms of anxiety and depression were evaluated with the Hospital Anxiety Depression Scale (HAD) (defined cut-off≥8).

Results: 9.2% the patients had limited SSc, 50.5% limited cutaneous SSc (lcSSc), and 40.3% diffuse cutaneous SSc (dcSSc). Overall, 40.4% and 58.8% of the patients had clinically significant symptoms of depression and anxiety, respectively. Compared to patients without clinically significant symptoms of depression, patients with clinically significant symptoms of depression had poorer health status, HRQoL mental and physical component, and greater global disability, hand disability and aesthetic impairment. Compared to patients without clinically significant symptoms of anxiety, patients with clinically significant symptoms of anxiety had poorer SF-36 mental and physical component scores. On multivariable analysis, excluding mental component score of SF-36, variables independently associated with clinically significant symptoms of depression and anxiety were global disability and physical component of SF-36, plus female gender for clinically significant symptoms of anxiety only. Remarkably, patients with and without clinically significant psychiatric symptoms were comparable for all disease-related clinical features assessed.

Conclusion: High levels of clinically significant symptoms of anxiety and depression are observed among SSc patients. Clinically significant psychiatric symptoms are rather associated with increased disability and altered HRQoL, than with disease-specific organ manifestations.

Citing Articles

Assessing the psychometric properties of the World Health Organization -five well-being index (WHO-5) in Filipino samples amid the COVID-19 pandemic.

Gallemit I, Mordeno I, Simon P, Ferolino M BMC Psychol. 2024; 12(1):580.

PMID: 39427223 PMC: 11491023. DOI: 10.1186/s40359-024-01941-0.

Emotional intelligence: a novel predictor of quality of life in patients with systemic sclerosis.

Karagianni D, Simopoulou T, Bogdanos D, Sakkas L Rheumatol Int. 2024; 44(10):1967-1974.

PMID: 38995416 DOI: 10.1007/s00296-024-05656-8.

Assessing hand and global disability in a cohort of Algerian patients with systemic sclerosis: Construct validities of the Arab Hand Function Index and the Arabic Health Assessment Questionnaire.

Benmostefa N, Malek R, Robert M, Chaigne B, Slimani S, Rouabhia S J Scleroderma Relat Disord. 2024; 9(2):134-142.

PMID: 38910602 PMC: 11188850. DOI: 10.1177/23971983241231082.

Perception of aesthetic impairment in patients with systemic sclerosis determined using a semi-quantitative scale and its association with disease characteristics.

Farhat M, Guerreschi P, Morell-Dubois S, Deken V, Labreuche J, Sanges S J Scleroderma Relat Disord. 2024; 9(2):124-133.

PMID: 38910601 PMC: 11188849. DOI: 10.1177/23971983241231620.

The effect of a self-management program on the quality of life of patients with scleroderma.

Parniyan R, Pasyar N, Rambod M, Momennasab M, Nazarinia M J Educ Health Promot. 2024; 12:440.

PMID: 38464627 PMC: 10920719. DOI: 10.4103/jehp.jehp_1690_22.

References

Mouthon L, Rannou F, Berezne A, Pagnoux C, Guilpain P, Goldwasser F . Patient preference disability questionnaire in systemic sclerosis: a cross-sectional survey. Arthritis Rheum. 2008; 59(7):968-73. DOI: 10.1002/art.23819. View

Andrews D, Scott C, Sperduto P, Flanders A, Gaspar L, Schell M . Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet. 2004; 363(9422):1665-72. DOI: 10.1016/S0140-6736(04)16250-8. View

Heinberg L, Kudel I, White B, Kwan A, Medley K, Wigley F . Assessing body image in patients with systemic sclerosis (scleroderma): validation of the adapted Satisfaction with Appearance Scale. Body Image. 2007; 4(1):79-86. PMC: 2031840. DOI: 10.1016/j.bodyim.2006.11.002. View

Merkel P, Herlyn K, Martin R, Anderson J, Mayes M, Bell P . Measuring disease activity and functional status in patients with scleroderma and Raynaud's phenomenon. Arthritis Rheum. 2002; 46(9):2410-20. DOI: 10.1002/art.10486. View

Johnson S, Hawker G, Davis A . The health assessment questionnaire disability index and scleroderma health assessment questionnaire in scleroderma trials: an evaluation of their measurement properties. Arthritis Rheum. 2005; 53(2):256-62. DOI: 10.1002/art.21084. View

Poole J . Grasp pattern variations seen in the scleroderma hand. Am J Occup Ther. 1994; 48(1):46-54. DOI: 10.5014/ajot.48.1.46. View

Bjelland I, Dahl A, Haug T, Neckelmann D . The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002; 52(2):69-77. DOI: 10.1016/s0022-3999(01)00296-3. View

Jewett L, Razykov I, Hudson M, Baron M, Thombs B . Prevalence of current, 12-month and lifetime major depressive disorder among patients with systemic sclerosis. Rheumatology (Oxford). 2012; 52(4):669-75. DOI: 10.1093/rheumatology/kes347. View

Nguyen C, Poiraudeau S, Mestre-Stanislas C, Rannou F, Berezne A, Papelard A . Employment status and socio-economic burden in systemic sclerosis: a cross-sectional survey. Rheumatology (Oxford). 2010; 49(5):982-9. DOI: 10.1093/rheumatology/kep400. View

10.

Ware Jr J, Sherbourne C . The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992; 30(6):473-83. View

11.

Steen V, Medsger Jr T . Severe organ involvement in systemic sclerosis with diffuse scleroderma. Arthritis Rheum. 2000; 43(11):2437-44. DOI: 10.1002/1529-0131(200011)43:11<2437::AID-ANR10>3.0.CO;2-U. View

12.

Straat J, van der Ark L, Sijtsma K . Methodological artifacts in dimensionality assessment of the hospital anxiety and depression scale (HADS). J Psychosom Res. 2013; 74(2):116-21. DOI: 10.1016/j.jpsychores.2012.11.012. View

13.

Honarmand K, Feinstein A . Validation of the Hospital Anxiety and Depression Scale for use with multiple sclerosis patients. Mult Scler. 2009; 15(12):1518-24. DOI: 10.1177/1352458509347150. View

14.

Straszecka J, Kucharz E, JONDERKO G, Kotulska A, Brzezinska-Wcislo L, RUBISZ-BRZEZINSKA J . Depression and anxiety in patients with systemic sclerosis. Clin Rheumatol. 1996; 15(6):621. DOI: 10.1007/BF02238557. View

15.

Evans C, McCarthy M . Prognostic uncertainty in terminal care: can the Karnofsky index help?. Lancet. 1985; 1(8439):1204-6. DOI: 10.1016/s0140-6736(85)92876-4. View

16.

Mura G, Bhat K, Pisano A, Licci G, Carta M . Psychiatric symptoms and quality of life in systemic sclerosis. Clin Pract Epidemiol Ment Health. 2012; 8:30-5. PMC: 3339425. DOI: 10.2174/1745017901208010030. View

17.

Hachulla E, Gressin V, Guillevin L, Carpentier P, Diot E, Sibilia J . Early detection of pulmonary arterial hypertension in systemic sclerosis: a French nationwide prospective multicenter study. Arthritis Rheum. 2005; 52(12):3792-800. DOI: 10.1002/art.21433. View

18.

Pope J . Measures of systemic sclerosis (scleroderma): Health Assessment Questionnaire (HAQ) and Scleroderma HAQ (SHAQ), physician- and patient-rated global assessments, Symptom Burden Index (SBI), University of California, Los Angeles, Scleroderma Clinical.... Arthritis Care Res (Hoboken). 2012; 63 Suppl 11:S98-111. DOI: 10.1002/acr.20598. View

19.

Baubet T, Ranque B, Taieb O, Berezne A, Bricou O, Mehallel S . Mood and anxiety disorders in systemic sclerosis patients. Presse Med. 2010; 40(2):e111-9. DOI: 10.1016/j.lpm.2010.09.019. View

20.

Berezne A, Seror R, Morell-Dubois S, de Menthon M, Fois E, Dzeing-Ella A . Impact of systemic sclerosis on occupational and professional activity with attention to patients with digital ulcers. Arthritis Care Res (Hoboken). 2010; 63(2):277-85. DOI: 10.1002/acr.20342. View