[1] Varan Ö, Babaoğlu H, Göker B. Associations between
depressive disorders and inflammatory rheumatic diseases.
Curr Top Med Chem 2018; 18(16):1395-1401.
[2] Lisitsyna TA, Veltishchev DY, Seravina OF, Kovalevskaya OB,
Starovoytova MN, Desinova OV, et al. Comparative analysis
of anxiety-depressive spectrum disorders in patients with
rheumatic diseases. Ter Arkh 2018; 90(5):30-37.
[3] Gök K, Cengiz G, Erol K, Özgöçmen S. The Turkish version of
multidimensional assessment of fatigue and fatigue severity
scale is reproducible and correlated with other outcome
measures in patients with systemic sclerosis. Arch Rheumatol
2016; 31(4):329-332.
[4] Grygiel-Górniak B, Limphaibool N, Puszczewicz M. Cytokine
secretion and the risk of depression development in patients
with connective tissue diseases. Psychiatry Clin Neurosci 2019;
73(6):302-316.
[5] Ware J, Snow K, Kosinski M, Gandek B. SF-36 health survey.
Manual and interpretation guide. Boston, MA: New England
Medical Center The Health Institute. 1993; 98(1-2):91-97.
[6] Aydemir O. Validity and reliability of Turkish version of hospital
anxiety and depression scale. Turkish Journal of Psychiatry
1997; 8(4):280-287
[7] Tarakçı E, Arman N, Barut K, Şahin S, Adroviç A, Kasapçopur
Ö. Fatigue and sleep in children and adolescents with juvenile
idiopathic arthritis: a cross-sectional study. Turk J Med Sci
2019; 49(1):58-65.
[8] Kojima M, Kojima T, Waguri-Nagaya Y, Takahashi N, Asai S,
Sobue Y. Depression, physical function, and disease activity
associated with frailty in patients with rheumatoid arthritis.
Mod Rheumatol 2021; 31(5):979-986
[9] Imran MY, Saira Khan EA, Ahmad NM, Farman Raja S, Saeed
MA, Ijaz Haider I. Depression in rheumatoid arthritis and its
relation to disease activity. Pak J Med Sci 2015; 31(2):393-7.
[10] Figueiredo-Braga M, Cornaby C, Cortez A, Bernardes M,
Terroso G, Figueiredo M. Influence of biological therapeutics,
cytokines, and disease activity on depression in rheumatoid
arthritis. J Immunol Res 2018; 2018:5954897.
[11] Žagar I, Delimar V, Pap M, Perić D, Laktašić Žerjavić N, Perić
P. Prevalence and correlation of depressive symptoms with
functional scores, therapy and disease activity among Croatian
patients with rheumatoid arthritis: a preliminary study.
Psychiatr Danub 2018; 30 (4):452-458.
[12] Englbrecht M, Alten R, Aringer M, Baerwald CG, Burkhardt H,
Eby N. New insights into the prevalence of depressive symptoms
and depression in rheumatoid arthritis – Implications from the prospective multicenter VADERA II study. PLoS One 2019; 14(5):e0217412.
[13] Gök K, Erol K, Cengiz G, Özgöçmen S. Comparison of level of
fatigue and disease correlates in patients with rheumatoid
arthritis and systemic sclerosis. Arch Rheumatol. 2018;
33(3):316-321.
[14] Tay SH, Cheung PP, Mak A. Active disease is independently
associated with more severe anxiety rather than depressive
symptoms in patients with systemic lupus erythematosus.
Lupus 2015; 2 4(13):1392-1399.
[15] Skinner-Taylor CM, Perez-Barbosa L, Corral-Trujillo ME, Perez-
Onofre I, Barriga-Maldonado ES, Cardenas-de la Garza JA. Anxiety and depression in reproductive age women with rheumatic diseases. Rheumatol Int 2020; 40(9):1433-1438.
[16] Azizoddin DR, Gandhi N, Weinberg S, Sengupta M, Nicassio
PM, Jolly M. Fatigue in systemic lupus: the role of disease
activity and its correlates. Lupus. 2019; 28(2):163-173.
[17] Alsowaida N, Alrasheed M, Mayet A, Alsuwaida A, Omair
MA. Medication adherence, depression, and disease activity
among patients with systemic lupus erythematosus. Lupus
2018; 27(2):327-332
[18] Margiotta DPE, Fasano S, Basta F, Pierro L, Riccardi A,
Navarini L. Clinical features of patients with systemic lupus
erythematosus according to health-related quality of life,
entity of pain, fatigue and depression: a cluster analysis. Clin
Exp Rheumatol 2019; 37(4):535-539.
[19] Margiotta DPE, Fasano S, Basta F, Pierro L, Riccardi A, Navarini
L. The association between duration of remission, fatigue,
depression and health-related quality of life in Italian patients
with systemic lupus erythematosus. Lupus 2019; 28(14):1705-
1711.
[20] Choi ST, Kang JI, Park IH, Lee YW, Song JS, Park YB. Subscale
analysis of quality of life in patients with systemic lupus
erythematosus: association with depression, fatigue, disease
activity and damage. Clin Exp Rheumatol 2012; 30(5):665-72.
[21] Arnaud L, Mertz P, Amoura Z, Voll RE, Schwarting A, Maurier
F. Patterns of fatigue and association with disease activity
and clinical manifestations in systemic lupus erythematosus.
Rheumatology (Oxford) 2020; 60(6):2672-2677
[22] Yilmaz-Oner S, Oner C, Dogukan FM, Moses TF, Demir K,
Tekayev N. Anxiety and depression predict quality of life in
Turkish patients with systemic lupus erythematosus. Clin Exp
Rheumatol 2015; 33(3):360-5.
[23] Mok CC, Chan KL, Ho LY. Association of depressive/anxiety
symptoms with quality of life and workability in patients with
systemic lupus erythematosus. Clin Exp Rheumatol 2016;
34(3):389-95.
[24] Cui Y, Xia L, Li L, Zhao Q, Chen S, Gu Z. Anxiety and depression
in primary Sjögren’s syndrome: a cross-sectional study. BMC
Psychiatry 2018; 18(1):131.
[25] Milin M, Cornec D, Chastaing M, Griner V, Berrouiguet S,
Nowak E, Marhadour T, Saraux A, Devauchelle-Pensec V.
Sicca symptoms are associated with similar fatigue, anxiety,
depression, and quality-of-life impairments in patients with
and without primary Sjögren’s syndrome. Joint Bone Spine
2016; 83(6):681-685.
[26] Koçer B, Tezcan ME, Batur HZ, Haznedaroğlu Ş, Göker B,
İrkeç C. Cognition, depression, fatigue, and quality of life in
primary Sjögren’s syndrome: correlations. Brain Behav 2016;
6(12):e00586.
[27] Kotsis K, Voulgari PV, Tsifetaki N, Drosos AA, Carvalho AF,
Hyphantis T. Illness perceptions and psychological distress
associated with physical health-related quality of life in
primary Sjögren’s syndrome compared to systemic lupus
erythematosus and rheumatoid arthritis. Rheumatol Int 2014;
34(12):1671-81.
[28] Del Rosso A, Mikhaylova S, Baccini M, Lupi I, Matucci Cerinic
M, Maddali Bongi S. In systemic sclerosis, anxiety and
depression assessed by hospital anxiety depression scale are
independently associated with disability and psychological
factors. Biomed Res Int 2013; 2013:507493.
[29] March C, Huscher D, Preis E, Makowka A, Hoeppner J,
Buttgereit F. Prevalence, risk factors and assessment of
depressive symptoms in patients with systemic sclerosis. Arch
Rheumatol 2019; 34(3):253-261.
[30] Nguyen C, Ranque B, Baubet T, Bérezné A, Mestre-Stanislas
C, Rannou F. 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 2014; 9(2):e90484.
[31] Park EH, Strand V, Oh YJ, Song YW, Lee EB. Health-related
quality of life in systemic sclerosis compared with other
rheumatic diseases: a cross-sectional study. Arthritis Res Ther
2019; 21(1):61.
Psychological Morbidity, Fatigue and Burden of Disease in Patients With Connective Tissue Diseases
Objective: Depression and anxiety disorders are significant health problems that can coexist with other diseases and exert adverse effects on these diseases’ course and treatment response. Fatigue is a common and disabling symptom in chronic inflammatory diseases. The present study aimed to evaluate the fatigue, anxiety, depression and burden of disease (eg, disease activity, function, quality of life) in autoimmune connective tissue disease (CTD) patients.
Methods: 160 patients diagnosed with CTD and 50 healthy control patients were included in the present study. Disease activity scores were recorded. All patients were asked to fill the Short Form-36, Fatigue Severity Scale, Hospital Depression and Anxiety Scale (HADS).
Results: In all patients groups, anxiety, depression, and fatigue scores were significantly higher, and quality of life scores significantly lower than those of healthy controls. A significant positive correlation was found between rheumatoid arthritis activity, HADS anxiety and depression scores. It was also established that in scleroderma patients with diffuse skin involvement and pulmonary involvement, depression and anxiety scores were high.
Conclusion: It is clear that psychiatric comorbidity and fatigue may be present in CTD and adversely affects quality of life. It is important to assess them and they should be an important treatment target.
[1] Varan Ö, Babaoğlu H, Göker B. Associations between
depressive disorders and inflammatory rheumatic diseases.
Curr Top Med Chem 2018; 18(16):1395-1401.
[2] Lisitsyna TA, Veltishchev DY, Seravina OF, Kovalevskaya OB,
Starovoytova MN, Desinova OV, et al. Comparative analysis
of anxiety-depressive spectrum disorders in patients with
rheumatic diseases. Ter Arkh 2018; 90(5):30-37.
[3] Gök K, Cengiz G, Erol K, Özgöçmen S. The Turkish version of
multidimensional assessment of fatigue and fatigue severity
scale is reproducible and correlated with other outcome
measures in patients with systemic sclerosis. Arch Rheumatol
2016; 31(4):329-332.
[4] Grygiel-Górniak B, Limphaibool N, Puszczewicz M. Cytokine
secretion and the risk of depression development in patients
with connective tissue diseases. Psychiatry Clin Neurosci 2019;
73(6):302-316.
[5] Ware J, Snow K, Kosinski M, Gandek B. SF-36 health survey.
Manual and interpretation guide. Boston, MA: New England
Medical Center The Health Institute. 1993; 98(1-2):91-97.
[6] Aydemir O. Validity and reliability of Turkish version of hospital
anxiety and depression scale. Turkish Journal of Psychiatry
1997; 8(4):280-287
[7] Tarakçı E, Arman N, Barut K, Şahin S, Adroviç A, Kasapçopur
Ö. Fatigue and sleep in children and adolescents with juvenile
idiopathic arthritis: a cross-sectional study. Turk J Med Sci
2019; 49(1):58-65.
[8] Kojima M, Kojima T, Waguri-Nagaya Y, Takahashi N, Asai S,
Sobue Y. Depression, physical function, and disease activity
associated with frailty in patients with rheumatoid arthritis.
Mod Rheumatol 2021; 31(5):979-986
[9] Imran MY, Saira Khan EA, Ahmad NM, Farman Raja S, Saeed
MA, Ijaz Haider I. Depression in rheumatoid arthritis and its
relation to disease activity. Pak J Med Sci 2015; 31(2):393-7.
[10] Figueiredo-Braga M, Cornaby C, Cortez A, Bernardes M,
Terroso G, Figueiredo M. Influence of biological therapeutics,
cytokines, and disease activity on depression in rheumatoid
arthritis. J Immunol Res 2018; 2018:5954897.
[11] Žagar I, Delimar V, Pap M, Perić D, Laktašić Žerjavić N, Perić
P. Prevalence and correlation of depressive symptoms with
functional scores, therapy and disease activity among Croatian
patients with rheumatoid arthritis: a preliminary study.
Psychiatr Danub 2018; 30 (4):452-458.
[12] Englbrecht M, Alten R, Aringer M, Baerwald CG, Burkhardt H,
Eby N. New insights into the prevalence of depressive symptoms
and depression in rheumatoid arthritis – Implications from the prospective multicenter VADERA II study. PLoS One 2019; 14(5):e0217412.
[13] Gök K, Erol K, Cengiz G, Özgöçmen S. Comparison of level of
fatigue and disease correlates in patients with rheumatoid
arthritis and systemic sclerosis. Arch Rheumatol. 2018;
33(3):316-321.
[14] Tay SH, Cheung PP, Mak A. Active disease is independently
associated with more severe anxiety rather than depressive
symptoms in patients with systemic lupus erythematosus.
Lupus 2015; 2 4(13):1392-1399.
[15] Skinner-Taylor CM, Perez-Barbosa L, Corral-Trujillo ME, Perez-
Onofre I, Barriga-Maldonado ES, Cardenas-de la Garza JA. Anxiety and depression in reproductive age women with rheumatic diseases. Rheumatol Int 2020; 40(9):1433-1438.
[16] Azizoddin DR, Gandhi N, Weinberg S, Sengupta M, Nicassio
PM, Jolly M. Fatigue in systemic lupus: the role of disease
activity and its correlates. Lupus. 2019; 28(2):163-173.
[17] Alsowaida N, Alrasheed M, Mayet A, Alsuwaida A, Omair
MA. Medication adherence, depression, and disease activity
among patients with systemic lupus erythematosus. Lupus
2018; 27(2):327-332
[18] Margiotta DPE, Fasano S, Basta F, Pierro L, Riccardi A,
Navarini L. Clinical features of patients with systemic lupus
erythematosus according to health-related quality of life,
entity of pain, fatigue and depression: a cluster analysis. Clin
Exp Rheumatol 2019; 37(4):535-539.
[19] Margiotta DPE, Fasano S, Basta F, Pierro L, Riccardi A, Navarini
L. The association between duration of remission, fatigue,
depression and health-related quality of life in Italian patients
with systemic lupus erythematosus. Lupus 2019; 28(14):1705-
1711.
[20] Choi ST, Kang JI, Park IH, Lee YW, Song JS, Park YB. Subscale
analysis of quality of life in patients with systemic lupus
erythematosus: association with depression, fatigue, disease
activity and damage. Clin Exp Rheumatol 2012; 30(5):665-72.
[21] Arnaud L, Mertz P, Amoura Z, Voll RE, Schwarting A, Maurier
F. Patterns of fatigue and association with disease activity
and clinical manifestations in systemic lupus erythematosus.
Rheumatology (Oxford) 2020; 60(6):2672-2677
[22] Yilmaz-Oner S, Oner C, Dogukan FM, Moses TF, Demir K,
Tekayev N. Anxiety and depression predict quality of life in
Turkish patients with systemic lupus erythematosus. Clin Exp
Rheumatol 2015; 33(3):360-5.
[23] Mok CC, Chan KL, Ho LY. Association of depressive/anxiety
symptoms with quality of life and workability in patients with
systemic lupus erythematosus. Clin Exp Rheumatol 2016;
34(3):389-95.
[24] Cui Y, Xia L, Li L, Zhao Q, Chen S, Gu Z. Anxiety and depression
in primary Sjögren’s syndrome: a cross-sectional study. BMC
Psychiatry 2018; 18(1):131.
[25] Milin M, Cornec D, Chastaing M, Griner V, Berrouiguet S,
Nowak E, Marhadour T, Saraux A, Devauchelle-Pensec V.
Sicca symptoms are associated with similar fatigue, anxiety,
depression, and quality-of-life impairments in patients with
and without primary Sjögren’s syndrome. Joint Bone Spine
2016; 83(6):681-685.
[26] Koçer B, Tezcan ME, Batur HZ, Haznedaroğlu Ş, Göker B,
İrkeç C. Cognition, depression, fatigue, and quality of life in
primary Sjögren’s syndrome: correlations. Brain Behav 2016;
6(12):e00586.
[27] Kotsis K, Voulgari PV, Tsifetaki N, Drosos AA, Carvalho AF,
Hyphantis T. Illness perceptions and psychological distress
associated with physical health-related quality of life in
primary Sjögren’s syndrome compared to systemic lupus
erythematosus and rheumatoid arthritis. Rheumatol Int 2014;
34(12):1671-81.
[28] Del Rosso A, Mikhaylova S, Baccini M, Lupi I, Matucci Cerinic
M, Maddali Bongi S. In systemic sclerosis, anxiety and
depression assessed by hospital anxiety depression scale are
independently associated with disability and psychological
factors. Biomed Res Int 2013; 2013:507493.
[29] March C, Huscher D, Preis E, Makowka A, Hoeppner J,
Buttgereit F. Prevalence, risk factors and assessment of
depressive symptoms in patients with systemic sclerosis. Arch
Rheumatol 2019; 34(3):253-261.
[30] Nguyen C, Ranque B, Baubet T, Bérezné A, Mestre-Stanislas
C, Rannou F. 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 2014; 9(2):e90484.
[31] Park EH, Strand V, Oh YJ, Song YW, Lee EB. Health-related
quality of life in systemic sclerosis compared with other
rheumatic diseases: a cross-sectional study. Arthritis Res Ther
2019; 21(1):61.
Tezcan, D., Gülcemal, S., Körez, M. K., Yilmaz, S. (2022). Psychological Morbidity, Fatigue and Burden of Disease in Patients With Connective Tissue Diseases. Clinical and Experimental Health Sciences, 12(2), 285-293. https://doi.org/10.33808/clinexphealthsci.983685
AMA
Tezcan D, Gülcemal S, Körez MK, Yilmaz S. Psychological Morbidity, Fatigue and Burden of Disease in Patients With Connective Tissue Diseases. Clinical and Experimental Health Sciences. June 2022;12(2):285-293. doi:10.33808/clinexphealthsci.983685
Chicago
Tezcan, Dilek, Semral Gülcemal, Muslu Kazım Körez, and Sema Yilmaz. “Psychological Morbidity, Fatigue and Burden of Disease in Patients With Connective Tissue Diseases”. Clinical and Experimental Health Sciences 12, no. 2 (June 2022): 285-93. https://doi.org/10.33808/clinexphealthsci.983685.
EndNote
Tezcan D, Gülcemal S, Körez MK, Yilmaz S (June 1, 2022) Psychological Morbidity, Fatigue and Burden of Disease in Patients With Connective Tissue Diseases. Clinical and Experimental Health Sciences 12 2 285–293.
IEEE
D. Tezcan, S. Gülcemal, M. K. Körez, and S. Yilmaz, “Psychological Morbidity, Fatigue and Burden of Disease in Patients With Connective Tissue Diseases”, Clinical and Experimental Health Sciences, vol. 12, no. 2, pp. 285–293, 2022, doi: 10.33808/clinexphealthsci.983685.
ISNAD
Tezcan, Dilek et al. “Psychological Morbidity, Fatigue and Burden of Disease in Patients With Connective Tissue Diseases”. Clinical and Experimental Health Sciences 12/2 (June 2022), 285-293. https://doi.org/10.33808/clinexphealthsci.983685.
JAMA
Tezcan D, Gülcemal S, Körez MK, Yilmaz S. Psychological Morbidity, Fatigue and Burden of Disease in Patients With Connective Tissue Diseases. Clinical and Experimental Health Sciences. 2022;12:285–293.
MLA
Tezcan, Dilek et al. “Psychological Morbidity, Fatigue and Burden of Disease in Patients With Connective Tissue Diseases”. Clinical and Experimental Health Sciences, vol. 12, no. 2, 2022, pp. 285-93, doi:10.33808/clinexphealthsci.983685.
Vancouver
Tezcan D, Gülcemal S, Körez MK, Yilmaz S. Psychological Morbidity, Fatigue and Burden of Disease in Patients With Connective Tissue Diseases. Clinical and Experimental Health Sciences. 2022;12(2):285-93.