Prevalence, Risk Factors and Assessment of Depressive Symptoms in Patients With Systemic Sclerosis

Abstract

Objectives: This study aims to evaluate the prevalence of depressive symptoms among systemic sclerosis (SSc) patients using the Major Depression Inventory (MDI), identify possible risk factors, and analyze the current standard of care to raise awareness and improve clinical care for SSc patients. Patients and methods: The study included 94 SSc patients (12 males, 82 females; mean age 58.3±13.6 years; range, 28 to 83 years) who completed the MDI, Short Form 36 Health Survey, Scleroderma Health Assessment Questionnaire, Brief Fatigue Inventory and Physical Activity Questionnaire. Clinical parameters were assessed according to standardized procedures. Discharge letters were analyzed for evaluation of depressive symptoms. Results: The prevalence of depressive symptoms was 22.3%. It correlated with female sex (p=0.047), underweight (p=0.002), fatigue (p<0.001), decreased quality of life (p<0.001) and less physical activity (p=0.048). The latter three were confirmed as independent risk factors in a multivariable regression analysis. The analysis of the current standard of care revealed no assessment of depressive symptoms in the majority of patients (89.4%), including 19 with depressive symptoms according to the MDI score. Conclusion: This study confirms the high prevalence of depressive symptoms in SSc patients. There is an unmet need of regular assessment of mental health during SSc consultations. Fatigue, decreased quality of life and reduced physical activity were ascertained as independent risk factors, while special attention should also be paid to weight loss and underweight.

Economic Burden and Management of Systemic Sclerosis-Associated Interstitial Lung Disease in 8 European Countries: The BUILDup Delphi Consensus Study

“…The results of our Delphi study showed that, according to the panellists, most SSc-ILD patients suffer from a number of comorbidities, such as gastroesophageal reflux disease (53.8%), fatigue (40.3%) or depression (22.6%). These results are consistent with the reports in the literature for SSc or SSc-ILD patients [32][33][34].…”

Validity and reliability of the Patient Health Questionnaire-8 in Swedish for individuals with systemic sclerosis

“…Depressive symptoms are associated with poor HRQL [ 8 ]. Patients with SSc who have depressive symptoms are also reported to be less physically active than those without depressive symptoms [ 9 ]. Further, depressive symptoms are associated with lower self-efficacy and reduced likelihood of adopting health-promoting behaviors [ 6 , 10 ].…”

Response to the Letter to the Editor: Prevalence, Risk Factors and Assessment of Depressive Symptoms in Patients With Systemic Sclerosis

“…At no point in our study did we claim that we assessed the prevalence of depression in SSc. 1 You might be right that the scientific value of estimating the prevalence of MDI-relevant items is limited. However, as we mention in the discussion of our paper, we want to raise the awareness for mental health issues in SSc without providing psychiatric diagnoses, measuring significant impairment or estimating the prevalence of depressive disorders in SSc.…”