Depressive symptoms in patients with systemic sclerosis: Association between clinical variables, functional status and the quality of life

Year 2013, Volume: 40 Issue: 1, 62 - 67, 01.03.2013

Mustafa Akif Sarıyıldız İbrahim Batmaz Mahmut Budulgan Levent Yazmalar Mehmet Okçu Mehmet Ali Ulu

https://doi.org/10.5798/diclemedj.0921.2013.01.0226

Abstract

Objective: The aim of this study is to evaluate the rela­tionship between the depressive symptoms with disease-related variables, functional status and quality of life in patients with systemic sclerosis (SSc). Material and methods: Forty patients diagnosed with SSc and 36 healthy control subjects were enrolled in the study. The demographic and clinical characteristics of the patients such as the Raynaud\'s phenomenon, SSc sub­type, digital ulcers, gastrointestinal and lung involvement and disease activity were recorded. All patients were as­sessed using the Short Form-36 Quality of Life (SF-36 QoL) scale, the Health Assessment Questionnaire (HAQ) and the Beck Depression Inventory (BDI). Generalized pain and fatigue was assessed with the Visual Analogue Scale. Results: The patients with SSc had significantly higher scores in the depressive symptoms in terms of the BDI score compared to the healthy control group. According to the results of Spearman\'s analysis, there was a sig­nificantly correlation between the depressive symptoms with education level, generalized pain, dyspnea, disease activity score, gastroesophageal reflux, dysphagia, func­tional status, mental and physical score of the SF-36. Conclusion: Depressive symptoms is enhanced in pa­tients with SSc. Depressive symptoms is especially asso­ciated with the generalised pain, disease activity, dyspha­gia, functional status, mental and quality of life in patients with SSc.

Keywords

Systemic sclerosis, depressive symptom, pain, functional status, quality of life

Sistemik sklerozlu hastalarda depresif semptomlar: Klinik değişkenler, fonksiyonel durum ve yaşam kalitesi ile ilişkisi

Abstract

Amaç: Bu çalışmanın amacı sistemik sklerozlu (SS) hastalarda depresif semptomların hastalıkla ilişkili değiş­kenler, fonksiyonel durum ve yaşam kalitesi ile ilişkisini değerlendirmektir. Gereç ve yöntem: Bu çalışmaya SS tanısı alan 40 hasta ve 36 sağlıklı kontrol grubu alındı. Hastaların reynaud fe­nomeni, SS alt tipi, dijital ülser, gastrointestinal ve akciğer tutulumu ve hastalık aktivitesi gibi klinik karakteristikleri kaydedildi. Tüm hastalara Short Form-36 (SF-36) yaşam kalitesi skalası, sağlık değerlendirme anketi ve Beck Dep­resyon ölçeği dolduruldu. Yaygın ağrı ve yorgunluk görsel analog skala ile değerlendirildi. Bulgular: Sistemik sklerozlu hastalarda sağlıklı kontrol grup ile kıyaslandığında depresif semptom skorları an­lamlı olarak yüksekti. Spearman korelasyon analizinin sonuçlarına göre, depresif semptomlar ile eğitim seviyesi, yaygın ağrı, dispne, hastalık aktivite skoru, gastroözefa­geal reflü, disfaji, fonksiyonel durum ve SF-36\' nın mental ve fiziksel skoru arasında anlamlı korelasyon tespit edildi. Sonuç: Sistemik sklerozlu hastalarda depresif semptom­lar artmıştır. Sistemik sklerozlu hastalarda depresif semp­tomlar özellikle yaygın ağrı, hastalık aktivitesi, disfaji, fonksiyonel durum ve yaşam kalitesi ile ilişkilidir.

Keywords

Sistemik skleroz, depresif semptom, ağrı, fonksiyonel durum, yaşam kalitesi

References

• Thombs BD, Taillefer SS, Hudson M, Baron M. Depression in patients with systemic sclerosis: a systematic review of the evidence. Arthritis Rheum 2007;57:1089-97.
• Bassel M, Hudson M, Taillefer SS, Schieir O, Baron M, Thombs BD. Frequency and impact of symptoms expe- rienced by patients with systemicsclerosis: results from a Canadian National Survey. Rheumatology (Oxford) 2011;50:762-7.
• Hudson M, Thombs BD, Steele R, et al. Health-related qual- ity of life in systemic sclerosis: a systematic review. Arthri- tis Rheum 2009;61:1112-20.
• Malcarne VL, Greenbergs HL. Psychological adjustment to systemic sclerosis. Arthritis Care Res 1996;9:51-9.
• Van Lankveld WG, Vonk MC, Teunissen H, van den Hoogen FH. Appearance self-esteem in systemic sclerosis subjec- tive experience of skin deformity and its relationship with physician-assessed skin involvement, disease status and psychological variables. Rheumatology 2007;46:872-6.
• Richards H, Herrick A, Griffin K, Gwilliam P, Fortune D. Psychological adjustment to systemic sclerosis exploring the association of disease factors, functional ability, body related attitudes and fear of negative evaluation. Psychol Health Med 2004;9:29-39.
• Thombs BD, Bassel M, McGuire L, Smith MT, Hudson M, Haythornthwaite JA. A systematic comparison of fa- tigue levels in systemic sclerosis with general population, cancer and rheumatic disease samples. Rheumatology 2008;47:1559-63.
• Thombs BD, Hudson M, Taillefer SS, Baron M. Canadian Scleroderma Research Group. Prevalence and clinical cor- relates of symptoms of depression in patients with systemic sclerosis. Arthritis Rheum 2008;59:504-9.
• Evans DL, Charney DS, Lewis L, et al. Mood disorders in the medically ill: scientific review and recommendations. Biol Psychiatry 2005;58:175-89.
• Benrud-Larson LM, Haythornthwaite JA, Heinberg LJ, et al. The impact of pain and symptoms of depression in scleroderma. Pain 2002;95:267-75.
• Haythornthwaite JA, Heinberg LJ, McGuire L. Psychologic factors in scleroderma [review]. Rheum Dis Clin North Am 2003;29:427-39.
• Bodukam V, Hays RD, Maranian P, et al. Association of gastrointestinal involvement and depressive symptoms in patients with systemic sclerosis. Rheumatology (Oxford) 2011;50:330-4.
• Sandusky SB, McGuire L, Smith MT, et al. Fatigue: an overlooked determinant of physical function in scleroder- ma. Rheumatology (Oxford) 2009;8:165-9.
• Prado GF, Allen RP, Trevisani VM, Toscano VG, Earley CJ. Sleep disruption in systemic sclerosis (scleroderma) pa- tients: clinical andpolysomnographic findings. Sleep Med 2002;3:341-5.
• Frech T, Hays RD, Maranian P, Clements PJ, Furst DE, Khanna D. Prevalence and correlates of sleep disturbance in systemic sclerosis--results from the UCLA scleroderma quality of life study. Rheumatology (Oxford) 2011;50:1280- 7.
• Clements P, Lachenbruch P, Siebold J, et al. Inter and in- traobserver variability of total skin thickness score (modi- fied Rodnan TSS) in systemic sclerosis. J Rheumatol 1995;22:1281-5.
• Valentini G, D’Angelo S, Della Rossa A, et al. European Scleroderma Study Group to define disease activity criteria for systemic sclerosis. IV. Assessment of skin thickening by modified Rodnan skin score. Ann Rheum Dis 2003;62:904- 5.
• Ware JE, Sherbourne CD. The MOS 36-item short form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473-83.
• Koçyiğit H, Aydemir Ö, Ölmez N, Memiş A. The validity and reliability of Turkish version of the short form 36 (SF- 36) Turkish J Drugs Therap 1999;112:102-6.
• Kucukdeveci AA, Sahin H, Ataman S, Griffiths B, Tennant A. Issues in cross-cultural validity: example from the adap- tation, reliability, and validity testing of a Turkish version of the Stanford health assessment questionnaire. Arthritis Rheum 2004;51:14-9.
• Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561-71.
• Lasa L, Ayuso-Mateos JL, Vazquez-Barquero JL, Díez- Manrique FJ, Dowrick CF. The use of Beck Depression In- ventory to screen for depression in the general population: a preliminary analysis. J Affect Disord 2000;57:261-5.
• Hisli N. A study on the validity of Beck Depression Inven- tory. J Psychol 1988;6:118-22.
• Müller H, Rehberger P, Günter C, et al. Determinants of disability, quality of life and depression in dermatological patients with systemic sclerosis. Br J Dermatol 2011;166: 343-53.
• Baubet T, Ranque B, Taïeb O, et al. Mood and anxiety disorders in systemic sclerosis patients. Presse Med 2011; 40:e111-9.
• Roca RP, Wigley FM, White B. Depressive symptoms as- sociated with scleroderma. Arthritis Rheum 1996;39:1035- 40.
• Danieli E, Airò P, Bettoni L, et al. Health-related quality of life measured by the Short Form 36 (SF-36) in systemic sclerosis: correlations with indexes of disease activity and severity, disability, and depressive symptoms. Clin Rheu- matol 2005;24:48-54.
• Legendre C, Allanore Y, Ferrand I, et al. Evaluation of de- pression and anxiety in patients with systemic sclerosis. Joint Bone Spine 2005;72:408-11.
• Beretta L, Astori S, Ferrario E, et al. Determinants of de- pression in 111 Italian patients with systemic sclerosis. Reumatismo 2006;58:219-25.
• Hardoy MC, Cadeddu M, Serra A, et al. A pattern of cerebral perfusion anomalies between major depressive disorder and hashimoto thyroiditis. BMC Psychiatry 2011;11:148-52.
• Edwards RR, Fillingim RB. Styles of pain coping predict cardiovascular function following a cold pressor test. Pain Res Menag 2005;10:219-22.
• Mura G, Bhat KM, Pisano A, Licci G, Carta M. Psychiat- ric symptoms and quality of life in systemic sclerosis. Clin Pract Epidemiol Ment Health 2012;8:30-5.
• Launay D, Baubet T, Cottencin O, et al. Neuropsychi- atric manifestations in systemic sclerosis. Presse Med 2010;39:539-47.
• Malcarne VL, Greenbergs HL. Psychological adjustment to systemic sclerosis. Arthritis Care Res 1996;9:51-9.