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

Abstract

The aim of this study was to evaluate health-related quality of life (HR-QOL) in patients with systemic sclerosis (SSc), to compare it with that of patients with rheumatoid arthritis (RA), and to correlate it with other parameters. HR-QOL was evaluated by the Short Form 36 (SF-36), SSc disease activity and severity by preliminary indexes recently proposed, disability by the Health Assessment Questionnaire (HAQ), and depressive symptoms by the Beck Depression Inventory. HR-QOL perception was not statistically different in patients with SSc and RA, except that patients with diffuse cutaneous involvement had worse scores in the general health and mental health dimensions than patients with RA (p=0.03). Compared with RA, patients with SSc tended to perceive less bodily pain (p=0.06) and have less disability (p=0.04) but to report higher depressive symptom scores (p=0.05). SSc patients' HR-QOL was associated with some disease severity scales (general, kidney and, less significantly, heart), but it was poorly correlated with the other evaluated disease activity and severity indexes. A strong correlation with disability and with depressive symptoms was observed. In conclusion, patients with SSc perceived a reduced HR-QOL similar to that of patients with RA. SF-36 may provide useful information in their evaluation.

Depression and functional impairment independently contribute to decreased quality of life in cancer patients prior to chemotherapy

“…The association of depression and QoL has been described for a variety of chronic diseases [20,28,29], but is less well studied in cancer patients [30]. Charlson et al reported a correlation of BDI with most scales of the EORTC-QLQ-C30, however they included 17 patients only [31].…”

Aplicabilidade do questionário de qualidade de vida relacionada à saúde - the 12-Item Short-Form Health Survey - em pacientes portadores de esclerose sistêmica progressiva

“…One possible explanation for this finding is that the disease has a greater impact on physical capacity than on mental health, this being the most likely explanation, since it reflects what has been identified in other studies. (3,(24)(25)(26)(27) Another possible explanation is that the MCS subscale has less discriminatory power.…”

Personality and Psychopathology in Patients with Systemic Sclerosis

“…Prevalence estimates range between 36 percent and 65 percent for depression [2] and between 19 percent and 64 percent for anxiety [3,4], percentages which considerably exceed those of the general population. In a comparative study scleroderma patients reported even more depressive symptoms on the Beck Depression scale, than rheumatoid arthritis (RA) patients, although analysing the scores on cognitive-affective items separately, no statistical difference was found between RA and SSc patients [5]. The great variability in reported prevalence rates of depression and anxiety was attributed to methodological issues [2], because it may derive from comparisons of studies using different measurement methods, the overlap between symptoms of SSc and somatic symptoms of depression involved in certain questionnaires, and the different populations sampled (differences in age, gender, disease severity, etc.).…”

“…Studies assessing correlates of depression and anxiety have provided inconsistent results regarding gender, age, marital status, educational level, severity and subset (limited or diffuse SSc) of the disease and organ involvement. They have, however, an established relationship with pain [6,7], functional status [5,8] and fatigue [6,9], because patients with worse functional status, or experiencing higher levels of pain or fatigue, tend to report more symptoms of anxiety and depression. Moreover, depression and anxiety are associated with impaired quality of life [5,10].…”