AB0422 Mental disorders and stress in sjögren’s syndrome patients

Abstract

Background The primary Sjögren’s Syndrome (SS) - a chronic, systemic autoimmune disease, characterized by lymphocytic infiltration of endocrine glands, functional impairment of the salivary and lachrymal glands, which has some common pathogenic links with stress-related mental disorders (MD). The physical and mental well being of the patients with primary SS are significantly reduced. The patients with SS have significantly high scoring rates for anxiety, depression, paranoid ideation and somatization compared to the controls. Objectives To evaluate the occurrence rate/severity of MD and the influence of stress factors in SS patients. Methods 50 inpatient women (mean age 46±13.2 yrs) suffering SS were enrolled in the study. MD were diagnosed in accordance with ICD-10 criteria. The severity of depression, anxiety, stress and fatigue were measured with MADRS, HAM-A, PSS-10 and FSS. Results The acute stress factors and reactions were preceded the SS symptoms in most cases (54%). The variants of stress factors revealed: “danger” (40%), “loss” (38%), “frustration” (16%) and “disaster” (6%). In most cases “loss”, “frustration”, “disaster” were related to acute and “danger” - chronic reactions (p<0,05). The adverse experience in childhood (parental deprivation mostly) had 32 (64%) of SS patients (recurrent events - 48%). MD had the significant provocative chronic stress factors in 36 (72%) patients. Mean severity level of stress (PSS10) was 16.9±6.04 points. High levels of daily stress had 17 (34%) of patients. MD were diagnosed in 42 (84%) of SS patients: depressive episode (mild/moderate; single/recurrent, 18%); dysthymia (18%); generalized anxiety disorder (14%); adjustment disorders (16%); schizotypal disorder (18%). Mean severity levels of anxiety and depression were 16.5±6.5 and 17.2±7.9 accordingly. Nearly one-third of patients had applied to psychiatrists in the past. Suicide attempts and suicidal thoughts had 6 (10%) and 10 (20%) patients accordingly before and during the disease. Fatiguewasone ofthe most often symptoms of SS revealed in most cases (60%). The severity of fatigue (Me 4.2±1.9 points) had significant correlations with the severity of anxiety and depression (r=0,4). Conclusions The study revealed high occurrence rate of MD, provocative stress factors and childhood adverse experience in SS patients. The results support the stress-diathesis model of mental disorders in patients suffering SS. Disclosure of Interest None Declared

Does stress response axis activation differ between patients with autoimmune disease and healthy people?

“…Specifically, patients with Sjögren's syndrome obtained worse scores than healthy women on mental health, depression, psychoticism and vulnerability to stress. These results are in line with those reported in other studies where patients with Sjögren's syndrome presented a higher rate of psychiatric disorders (Shelomkova et al, 2013). In addition, patients with Sjögren's syndrome and those with systemic sclerosis differed from healthy women regarding the quality-of-life variables of physical functioning, social functioning, and vitality.…”

“…Adverse childhood experiences and/or an absence of adaptive coping strategies in people with SS are related to a higher rate of psychological disorders compared to SLE patients and healthy people. Moreover, they often present difficulties in adapting to stressful life events, which is a risk factor for mental disorders (Shelomkova et al, 2013). In the same line, studies on the effects of psychological stress on SSc agree that this stress is a risk factor for SSc disease onset and exacerbation (Matsuura et al, 2011;Newton et al, 2012).…”