THU0020 Fatigue and Mental Disorders in Sjogren's Syndrome

Abstract

Background The physical and mental well being of patients with primary SS are significantly reduced [1]. Among the most significant causes are mental disorders and chronic fatigue, diagnosed in most patients suffering SS [2, 3, 4]. In the results of some previous studies fatigue had direct correlations with the diagnosis of depressive disorders but not with eyes/mouth dryness or immunology markers [3, 5]. Objectives To evaluate the occurrence rate/severity of fatigue and its relations with the severity of depression, anxiety and some clinical manifestations in SS patients. Methods 80 inpatients (mean age 46,2±12,3 yrs) suffering SS were enrolled in the study. Mental disorders (MD) were diagnosed in accordance with ICD-10 criteria. Mean age of patients during MD and SS manifestation - 31,18±14,6 and 34,6±13,3 acc. The severity of depression, anxiety, stress and fatigue were measured by HADS, MADRS, HAM-A, PSS-10 and FSS. Results Among the patients complaints had prevailed headaches (33.7%), eyes and mouth dryness (42.5%, 53.7%), memory decline (73.7%) and fatigue (93.75%). The severe fatigue (FSS) was revealed in 72.5% patients. FSS correlated with the depression severity (MADRS) (r=0.22), complaints on eyes dryness (r=0.26), cryoglobulins (r=0,25) level. The FSS score had significant correlations with anxiety and depression severity (HADS (r=0.38), WBI-WHO-5 (r=-0.52), HAM-A (r=0.34), MADRS (r=0.42) scores) and also menopausal period (r=0.32). MD were diagnosed in 78 (97.5%) of SS patients: depressive episode (mild/moderate; single/recurrent, n=27; 33.7%); dysthymia (n=12;15%); generalized anxiety disorder (n=9;11.3%); adjustment disorder (n=11;13.7%); schizotypal disorder (SD) (n=19;23.75%). Mean age of SS had significant direct correlation with the mean age of MD (r=0.82) manifestation. However, eyes/mouth dryness, immune disturbances, diagnosis of generalized vasculitis and lymphoma had pronounced correlations with the severity of anxiety and depression (MADRS and HAM-A scores). The significant differences in the occurrence rate of severe fatigue in different MD were not revealed. Conclusions Fatigue has significant associations both as with MD diagnosis (anxiety and depressive disorders) as clinical manifestations of SS. References Valtysdottir S.T., Gudbjornsson B., Lindqvist U, at al. Anxiety and depression in patients with primary Sjogren's syndrome. J Rheumatol. 2000;27:165 9. O Shelomkova, D Veltishchev, T Lisitsyna, V Vasiliev, O Kovalevskaya, O Seravina, V Krasnov, E Nasonov. Stress factors and mental disorders in Sjogren's syndrome: clinical-psychopathological and psychological analysis. J. Soc. I Clin. Psychiatry. 2013 (3): 36-42. Barendregt P., Visser M., Smets E. Fatigue in primary Sjögren's syndrome. Ann Rheum Dis. 1998 May; 57(5): 291–295. Segal B, Thomas W, Rogers T, at al. Prevalence, severity, and predictors of fatigue in subjects with primary Sjögren's syndrome. Arthritis Rheum.2008 Dec 15;59(12):1780-7. Tensing EK, Solovieva SA, Tervahartiala T, Nordstrom DC, Laine M, Ni...