Stress, coping strategies and social support in patients with primary Sjögren’s syndrome prior to disease onset: a retrospective case–control study

Karaiskos, D.; Mavragani, Clio P.; Makaroni, Sotiria; Zinzaras, Elias; Voulgarelis, Michael; Rabavilas, Andreas D.; Moutsopoulos, Haralampos Μ.

doi:10.1136/ard.2007.084152

Cited by 56 publications

(46 citation statements)

References 45 publications

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“…42 Increased rates of neuroticism, psychoticism, obsessiveness, hypochondriasis, paranoid ideation, somatization, obsessive-compulsive symptoms, sleep disturbances and defective coping strategies have been reported. 7,[43][44][45][46][47] Non-Hodgkin lymphoma is a well-recognized complication of Sjögren syndrome. 6,39 Peripheral neuropathy, glomerulonephritis, lymphopenia, vasculitis or purpuric lesions, low C4 levels, cryoglobulinemia and the presence of germinal centres in salivary gland biopsy samples are well-recognized adverse predictors of lymphoma.…”

Section: E580mentioning

confidence: 99%

Sjögren syndrome

Mavragani

Moutsopoulos

2014

CMAJ

153

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S jögren syndrome is a chronic, systemic disorder of an autoimmune nature. It is characterized by lymphocytic infiltration of the exocrine (mainly salivary and lacrimal) glands and by remarkable B-cell hyperactivity. The latter is manifested by hyper gam maglobulinemia and the presence of serum autoantibodies, including antinuclear antibodies, rheumatoid factor, cryoprecipitable immunoglobulins and antibodies against two ribonucleoproteinic complexes named Ro/SSA and La/SSB; these antibodies are considered hallmarks of the disease. 1,2Although their exact role is not known, recent data suggest that antibodies against the Ro52 component of the Ro/SSA antigen (a 52kD protein that inhibits proinflammatory responses) might inhibit its regulatory function.3 The condition is nine times more common among women than among men, with peak onset during menopause.1 A recent review suggests that the prevalence ranges from 0.1% to 4.8%, 1 with rates increasing with advanced age.4,5 Heterogeneity in inclusion criteria, ethnic origin, sample size and sex distribution between studies contributed to the observed variability.Although Sjögren syndrome is classically considered to be localized disease of the exo crine glands, mainly manifested with oral and ocular dryness, it also has a wide range of systemic clinical manifestations that affect essentially any organ system, and a small number of cases are complicated by the development of non-Hodgkin lymphoma.1,6 Secondary Sjögren syndrome is associated with an established connective-tissue disease.As is the case for many autoimmune diseases, the primary etiopathogenetic events are not known. The current hypothesis is that an interplay between environmental contributors (e.g., viruses, stress, hormones) and the patient's genetic background can lead to inflammatory responses against epithelial tissues. In this review, we summarize the current evidence, mostly from observational, open-label and randomized clinical trials, for the clinical manifestations, diagnosis and management of Sjögren syndrome (Box 1). What are the clinical features of Sjögren syndrome?The clinical features of Sjögren syndrome can be largely divided into those related to exocrine dysfunction (glandular) and those that affect organs other than the exocrine glands (extraglandular or systemic). The latter can be further divided into nonspecific features, those characterized by periepithelial infiltrates in parenchymal organs and those that result from immunocomplex deposition as a result of B-cell hyperactivity. 7,8 Most patients with Sjögren syndrome (about 90%) have an indolent benign course; however, a small but important number of cases (5%-10%) are complicated by immunocomplex pathology and lymphoid neoplasia, both of which are associated with high mortality (a 3.25-fold increase compared with the general population). 6,7,9

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Section: E580mentioning

confidence: 99%

Sjögren syndrome

Mavragani

Moutsopoulos

2014

CMAJ

153

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“…Stress has been advocated as being a forerunner of SS, since pSS patients experienced a high degree of stress prior to the onset of disease (Karaiskos et al, 2009). …”

Section: Stressmentioning

confidence: 99%

Primary Sjögren’s Syndrome: Current Pathophysiological, Diagnostic and Therapeutic Advances

Delporte¹,

Perret²,

Soyfoo³

2011

Autoimmune Disorders - Current Concepts and Advances From Bedside to Mechanistic Insights

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“…Согласно результатам масштабного исследования, наряду с депрессивными и тревожными расстройствами к наиболее часто встречающимся психическим рас-стройствам при БШ относят психотические состояния [32], в частности -неразвернутый параноидный син-дром в виде идей воздействия и отношения, являющие-ся значимым феноменом, отличающим БШ от других системных РЗ [33]. Некоторые авторы особо отмечают высокую встречаемость параноидных идей -примерно у 1/3 обследованных больных.…”

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“…В связи с этим особое значение в провокации БШ имеют стрессовые события в виде острой психической травмы либо длительной психотравмирующей ситуации, предше-ствующей (от 6 мес до 2 лет) началу аутоиммунного забо-левания [6,33]. В ретроспективном исследовании влия-ния стрессовых факторов, предшествующих заболева-нию, отмечается, что больные БШ по сравнению с конт-рольной группой указывают на значимо большее количе-ство негативных жизненных событий [33]. В результате сравнения пациентов с БШ, СКВ и с группой здоровых лиц выявлен более высокий уровень общего стресса при БШ [35].…”

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“…По данным исследований, депрессия оказывает большее влияние на снижение адаптации пациентов, чем тревож-ные расстройства [42]. Общее качество жизни при БШ страдает в большей степени, чем, например, при РА [29,33]. Следует отметить, что депрессивные расстройства и такие проявления, как боль и когнитивные наруше-ния, имеют наибольшее влияние на служебную дезадап-тацию [43].…”

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