Sistemik Skleroz Hastalarında Anksiyete, Depresyon ve Yaşam Kalitesinin Değerlendirilmesi: Diffüz ya da Limitli Tutulum Önemli mi?

Year 2022, , 161 - 167, 18.03.2022

Kevser Gök , Hatice Ecem Konak

https://doi.org/10.31832/smj.1043063

Abstract

Amaç: Sistemik skleroz (SSc) vaskülopati, deri ve organ fibrozu ile karakterize nadir görülen cilt tutulumu derecesine göre diffüz kutanöz SSc ve limitli kutanöz SSc olarak iki alt grubu olan kronik inflamatuvar bir hastalıktır. Bu çalışmada; diffüz ve limitli tip SSc hastalarında anksiyete, depresyon ve yaşam kalitesi parametrelerini incelemeyi ve iki grup arasında farklılık olup olmadığını değerlendirmeyi amaçladık.
Gereç ve Yöntemler: Çalışmaya Ankara Şehir Hastanesi romatoloji polikliniğine başvuran ve Amerikan Romatoloji Derneği (ACR) ve Avrupa Romatizma Birliği (EULAR) 2013 kriterlerine göre SSc tanısı ile takip edilen 42 hasta dahil edildi. Hastaların anksiyete ve depresyon yönünden riskini belirlemek, düzeyini ve şiddet değişikliğini ölçmek amacıyla Hastane Anksiyete Depresyon (HAD) Ölçeği ve yaşam kalitesini değerlendirmek için Nottingham Sağlık Profili (NHP) kullanıldı.
Bulgular: Limitli tip SSc hastalarında diffüz tip hastalara göre HAD anksiyete, NHP ağrı, NHP fiziksel aktivite, NHP yorgunluk ile NHP sosyal izolasyon skorları daha yüksek ve HAD depresyon, NHP emosyonel reaksiyon ve NHP toplam skorları daha düşük olmakla birlikte farklılıklar istatistiksel olarak anlamlı değildi (p>0.05).
Sonuç: Sonuç olarak her ne kadar limitli ve diffüz tip SSc hastalarının klinik özellikleri farklılık gösterse de, her iki tip hasta grubunda da anksiyete ve depresyon durumunun ve yaşam kalitesininin eşit miktarda etkilendiği gösterilmiştir. Bu nedenle her iki gruptaki hastalara bu açıdan benzer ölçüde önem verilmeli ve uygun tedavi yaklaşımında bulunulmalıdır.

Keywords

Sistemik skleroz, anksiyete, depresyon, yaşam kalitesi

References

• 1. LeRoy EC, Black C, Fleischmajer R, Jablonska S, Krieg T, Medsger Jr T, et al. (1988) Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. The Journal of rheumatology 15, 202-205.
• 2. Minier T, Nagy Z, Bálint Z, Farkas H, Radics J, Kumánovics G, et al. (2010) Construct validity evaluation of the European Scleroderma Study Group activity index, and investigation of possible new disease activity markers in systemic sclerosis. Rheumatology (Oxford, England) 49, 1133-1145.
• 3. Scussel-Lonzetti L, Joyal F, Raynauld JP, Roussin A, Rich E, Goulet JR, et al. (2002) Predicting mortality in systemic sclerosis: analysis of a cohort of 309 French Canadian patients with emphasis on features at diagnosis as predictive factors for survival. Medicine (Baltimore) 81, 154-167.
• 4. Benrud-Larson LM, Haythornthwaite JA, Heinberg LJ, Boling C, Reed J, White B, et al. (2002) The impact of pain and symptoms of depression in scleroderma. Pain 95, 267-275.
• 5. Nietert PJ, Mitchell HC, Bolster MB, Curran MY, Tilley BC, Silver RM (2005) Correlates of depression, including overall and gastrointestinal functional status, among patients with systemic sclerosis. The Journal of rheumatology 32, 51-57.
• 6. Suarez-Almazor ME, Kallen MA, Roundtree AK, Mayes M (2007) Disease and symptom burden in systemic sclerosis: a patient perspective. J Rheumatol 34, 1718-1726.
• 7. Benrud-Larson LM, Heinberg LJ, Boling C, Reed J, White B, Wigley FM, et al. (2003) Body image dissatisfaction among women with scleroderma: extent and relationship to psychosocial function. Health Psychology 22, 130.
• 8. Keillor JM, Barrett AM, Crucian GP, Kortenkamp S, Heilman KM (2002) Emotional experience and perception in the absence of facial feedback. Journal of the International Neuropsychological Society 8, 130-135.
• 9. Nguyen C, Ranque B, Baubet T, Bérezné A, Mestre-Stanislas C, Rannou F, et al. (2014) 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. PloS one 9, e90484.
• 10. Roca RP, Wigley FM, White B (1996) Depressive symptoms associated with scleroderma. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology 39, 1035-1040.
• 11. Radvanski DC. Coping processes as predictors of functional health outcomes and mental health in patients with scleroderma. Fielding Graduate University, 2015.
• 12. Matsuura E, Ohta A, Kanegae F, Haruda Y, Ushiyama O, Koarada S, et al. (2003) Frequency and analysis of factors closely associated with the development of depressive symptoms in patients with scleroderma. J Rheumatol 30, 1782-1787.
• 13. Kwakkenbos L, van Lankveld WG, Vonk MC, Becker ES, van den Hoogen FH, van den Ende CH (2012) Disease-related and psychosocial factors associated with depressive symptoms in patients with systemic sclerosis, including fear of progression and appearance self-esteem. J Psychosom Res 72, 199-204.
• 14. Thombs BD, Hudson M, Taillefer SS, Baron M, Group CSR (2008) Prevalence and clinical correlates of symptoms of depression in patients with systemic sclerosis. Arthritis Care & Research 59, 504-509.
• 15. Beretta L, Astori S, Ferrario E, Caronni M, Raimondi M, Scorza R (2006) Determinants of depression in 111 Italian patients with systemic sclerosis. Reumatismo 58, 219-225.
• 16. Wafki F, Amine B, Yacoub YI, Laatiriss A, Znat F, Abouqal R, et al. (2012) Depression among the Moroccan systemic sclerosis. Clinical rheumatology 31, 73-77.
• 17. Baubet T, Ranque B, Taïeb O, Bérezné A, Bricou O, Mehallel S, et al. (2011) Mood and anxiety disorders in systemic sclerosis patients. Presse medicale (Paris, France : 1983) 40, e111-119.
• 18. Waheed A, Hameed K, Khan AM, Syed JA, Mirza AI (2006) The burden of anxiety and depression among patients with chronic rheumatologic disorders at a tertiary care hospital clinic in Karachi, Pakistan. Journal of Pakistan Medical Association 56, 243.
• 19. Gum AM, Cheavens JS (2008) Psychiatric comorbidity and depression in older adults. Current psychiatry reports 10, 23-29.
• 20. Ostojic P, Zivojinovic S, Reza T, Damjanov N (2010) Symptoms of depression and anxiety in Serbian patients with systemic sclerosis: impact of disease severity and socioeconomic factors. Modern rheumatology 20, 353-357.
• 21. van den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A, et al. (2013) 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis and rheumatism 65, 2737-2747.
• 22. Clements P, Lachenbruch P, Siebold J, White B, Weiner S, Martin R, et al. (1995) Inter and intraobserver variability of total skin thickness score (modified Rodnan TSS) in systemic sclerosis. J Rheumatol 22, 1281-1285.
• 23. Aydemir O (1997) Hastane anksiyete ve depresyon olcegi Turkce formunun gecerlilik ve guvenilirligi. Turk Psikiyatri Derg 8, 187-280.
• 24. Kücükdeveci A, McKenna S, Kutlay S, Gürsel Y, Whalley D, Arasil T (2000) The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. International journal of rehabilitation research Internationale Zeitschrift fur Rehabilitationsforschung Revue internationale de recherches de readaptation 23, 31-38.
• 25. Hunt SM, McEwen J, McKenna SP (1985) Measuring health status: a new tool for clinicians and epidemiologists. The Journal of the Royal College of General Practitioners 35, 185-188.
• 26. Thombs BD, Taillefer SS, Hudson M, Baron M (2007) Depression in patients with systemic sclerosis: a systematic review of the evidence. Arthritis and rheumatism 57, 1089-1097.
• 27. Kuryłek A, Steuden S, Bogaczewicz J, Sysa-Jędrzejowska A, Woźniacka A (2008) Determinants of quality of life in patients with systemic sclerosis. Reumatologia/Rheumatology 46, 84-90.
• 28. Danieli E, Airo P, Bettoni L, Cinquini M, Antonioli CM, Cavazzana I, et al. (2005) 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. Clinical rheumatology 24, 48-54.
• 29. Hyphantis TN, Tsifetaki N, Pappa C, Voulgari PV, Siafaka V, Bai M, et al. (2007) Clinical features and personality traits associated with psychological distress in systemic sclerosis patients. Journal of psychosomatic research 62, 47-56.
• 30. Del Rosso A, Mikhaylova S, Baccini M, Lupi I, Matucci Cerinic M, Maddali Bongi S (2013) In systemic sclerosis, anxiety and depression assessed by hospital anxiety depression scale are independently associated with disability and psychological factors. BioMed research international 2013.
• 31. Faezi ST, Paragomi P, Shahali A, Akhlaghkhah M, Akbarian M, Akhlaghi M, et al. (2017) Prevalence and Severity of Depression and Anxiety in Patients With Systemic Sclerosis: An Epidemiologic Survey and Investigation of Clinical Correlates. Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases 23, 80-86.
• 32. Alonso J, Ferrer M, Gandek B, Ware JE, Aaronson NK, Mosconi P, et al. (2004) Health-related quality of life associated with chronic conditions in eight countries: results from the International Quality of Life Assessment (IQOLA) Project. Quality of life research 13, 283-298.
• 33. van Lankveld WG, Vonk MC, Teunissen H, van den Hoogen FH (2007) Appearance self-esteem in systemic sclerosis--subjective experience of skin deformity and its relationship with physician-assessed skin involvement, disease status and psychological variables. Rheumatology (Oxford, England) 46, 872-876.
• 34. Legendre C, Allanore Y, Ferrand I, Kahan A (2005) Evaluation of depression and anxiety in patients with systemic sclerosis. Joint Bone Spine 72, 408-411.
• 35. Angelopoulos NV, Drosos AA, Moutsopoulos HM (2001) Psychiatric symptoms associated with scleroderma. Psychotherapy and psychosomatics 70, 145-150.
• 36. Richards HL, Herrick AL, Griffin K, Gwilliam PD, Loukes J, Fortune DG (2003) Systemic sclerosis: patients' perceptions of their condition. Arthritis and rheumatism 49, 689-696.
• 37. Sierakowska M, Doroszkiewicz H, Sierakowska J, Olesińska M, Grabowska-Jodkowska A, Brzosko M, et al. (2019) Factors associated with quality of life in systemic sclerosis: a cross-sectional study. Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 28, 3347-3354.
• 38. Sierakowska M, Sierakowski S, Sierakowska J, Krajewska-Kułak E, Ndosi M (2018) Pain, fatigue and functional disability are associated with higher educational needs in systemic sclerosis: a cross-sectional study. Rheumatol Int 38, 1471-1478.
• 39. Schnitzer M, Hudson M, Baron M, Steele R (2011) Disability in systemic sclerosis -- a longitudinal observational study. J Rheumatol 38, 685-692.
• 40. Lumetti F, Barone L, Alfieri C, Silva M, Serra V, Delsante G, et al. (2015) Quality of life and functional disability in patients with interstitial lung disease related to Systemic Sclerosis. Acta bio-medica : Atenei Parmensis 86, 142-148