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Mood Problems and Depression in Systemic Sclerosis

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Practical Management of Systemic Sclerosis in Clinical Practice

Part of the book series: In Clinical Practice ((ICP))

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Abstract

Systemic sclerosis is a severe disease with skin and internal organ fibrosis. A progressive course, complications, functional limitations, multiple visits to the clinic, hospitalizations, an uncertain prognosis and disfigurements often lead to mood disorders, such as depression and anxiety. Mood disorders are common among scleroderma patients but, in many cases, are under-recognized because of the severe scleroderma course. Among other mood disorders, depression is the more common one; it may be moderate or severe in a significant proportion of patients and is associated with a severe negative impact on the patient’s quality of life, survival and mortality. Recognition of a mood disorder is crucial; discordance in a high prevalence of mood disorders and treatment may have a bad influence on patient’s compliance and coping with scleroderma. The education of patients and their family members is of great importance. The care of scleroderma patients, along with physical assessment, medicine prescription and physical rehabilitation, should include psychological assessment and support. Such an approach will provide patients with a better understanding of their condition and improve their coping with scleroderma.

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References

  1. Ostojic P, Zivojinovic S, Reza T, Damjanov N. Symptoms of depression and anxiety in Serbian patients with systemic sclerosis: impact of disease severity and socioeconomic factors. Mod Rheumatol. 2010;20:353–7. https://doi.org/10.1007/s10165-010-0285-7.

    Article  PubMed  Google Scholar 

  2. Kwakkenbos L, Delisle VC, Fox RS, et al. Psychosocial aspects of scleroderma. Rheum Dis Clin N Am. 2015;41:519–28. https://doi.org/10.1016/j.rdc.2015.04.010.

    Article  Google Scholar 

  3. Robinson D Jr, Eisenberg D, Nietert PJ, et al. Systemic sclerosis prevalence and comorbidities in systemic sclerosis prevalence and comorbidities in the US 2002-2002. Curr Med Res Opin. 2008;24:1157–66. https://doi.org/10.1185/030079908X280617.

    Article  PubMed  Google Scholar 

  4. Amaral TN, Peres FA, Lapa AT, Marques-Neto JF, Appenzeller S. Neurologic involvement in scleroderma: a systematic review. Semin Arthritis Rheum. 2013;43:335–47. https://doi.org/10.1016/j.semarthrit.2013.05.002.

    Article  PubMed  Google Scholar 

  5. Amoda O, Ravat V, Datta S, Saroha B, Patel RS. Trends in demographics , hospitalization outcomes , comorbidities , and mortality risk among systemic sclerosis patients. Cureus. 2018;10:e2628. https://doi.org/10.7759/cureus.2628.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Thombs BD, Taillefer SS, Hudson M, Baron M. Depression in patients with systemic sclerosis: a systematic review of the evidence. Arthritis Rheum. 2007;15(57):1089–97.

    Article  Google Scholar 

  7. Malcarne VL, Fox RS, Mills SD. Psychosocial aspects of systemic sclerosis. Curr Opin Rheumatol. 2013;25:707–13. https://doi.org/10.1097/01.bor.0000434666.47397.c2.

    Article  PubMed  Google Scholar 

  8. Hyphantis TN, Tsifetaki N, Siafaka V, et al. The impact of psychological arthritis, functioning upon systemic sclerosis patients’ quality of life. Semin Rheum. 2007;37:81–92.

    Article  Google Scholar 

  9. Bragazzi NL, Watad A, Gizunterman A, et al. The burden of depression in systemic sclerosis patients: a nationwide population-based study. J Affect Disord. 2019;243:427–31. https://doi.org/10.1016/j.jad.2018.09.075.

    Article  PubMed  Google Scholar 

  10. Leon L, Abasolo L, Redondo M, et al. Negative affect in systemic sclerosis. Rheumatol Int. 2014;34:597–604. https://doi.org/10.1007/s00296-013-2852-7.

    Article  PubMed  Google Scholar 

  11. Faezi ST, Paragomi P, Shahali A, et al. Prevalence and severity of depression and anxiety in patients with systemic sclerosis: an epidemiologic survey and investigation of clinical correlates. J Clin Rheumatol. 2017;23:80–6. https://doi.org/10.1097/RHU.0000000000000428.

    Article  PubMed  Google Scholar 

  12. Tedeschini E, Pingani L, Simoni E, et al. Correlation of articular involvement , skin disfigurement and unemployment with depressive symptoms in patients with systemic sclerosis : a hospital sample. Int J Rheum Dis. 2014;17:186–94. https://doi.org/10.1111/1756-185X.12100.

    Article  PubMed  Google Scholar 

  13. Razykov I, Hudson M, Baron M, Thombs BD. Utility of the patient health Questionnaire-9 to assess suicide risk in patients with systemic sclerosis. 2013;65:753–8. https://doi.org/10.1002/acr.21894.

  14. Jewett LR, Razykov I, Hudson M, Baron M, Thombs BD. Prevalence of current , 12-month and lifetime major depressive disorder among patients with systemic sclerosis. Rheumatology (Oxford). 2013;52:669–75. https://doi.org/10.1093/rheumatology/kes347.

    Article  Google Scholar 

  15. Singh MK, Clements PJ, Furst DE, Maranian P, Khanna D. Work productivity in scleroderma: analysis from the University of California, Los Angeles, scleroderma quality of life study. 2012;64:176–83. https://doi.org/10.1002/acr.20676.

  16. Nguyen C, Ranque B, Baubet T, et al. Clinical, functional and health-related quality of life correlates of clinically significant symptoms of anxiety and depression in patients with systemic sclerosis: a cross-sectional survey. PLoS One. 2014;9:e90484. https://doi.org/10.1371/journal.pone.0090484.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Lisitsyna TA, Veltishchev DY, Seravina OF, et al. Comparative analysis of anxiety-depressive spectrum disorders in patients with rheumatic diseases. Ter Arkh. 2018;11(90):30–7. https://doi.org/10.26442/terarkh201890530-37.

    Article  Google Scholar 

  18. Baubet T, Ranque B, Taïeb O, et al. Anxiété et dépression chez les patients atteints de sclérodermie systémique. Presse Med. 2011;40:e111–9. https://doi.org/10.1016/j.lpm.2010.09.019.

    Article  PubMed  Google Scholar 

  19. Van Lankveld WGJM, Vonk MC, Teunissen H, van den Hoogen FH. Appearance self-esteem in systemic sclerosis — subjective experience of skin deformity and its relationship with physician-assessed skin involvement , disease status and psychological variables. Rheumatology (Oxford). 2007;46:872–6. https://doi.org/10.1093/rheumatology/kem008.

    Article  Google Scholar 

  20. Irwin MR, Miller AH. Depressive disorders and immunity: 20 years of progress and discovery. Brain Behav Immun. 2007;21(4):374–83.

    Article  CAS  Google Scholar 

  21. Sariyildiz MA, Batmaz I, Budulgan M, et al. Sleep quality in patients with systemic sclerosis: relationship between the clinical variables, depressive symptoms, functional status, and the quality of life. Rheumatol Int. 2013;33:1973–9. https://doi.org/10.1007/s00296-013-2680-9.

    Article  PubMed  Google Scholar 

  22. Bassel M, Hudson M, Taillefer SS, Schieir O, Baron M, Thombs BD. Frequency and impact of symptoms experienced by patients with systemic sclerosis: results from a Canadian National Survey. Rheumatology (Oxford). 2011;50:762–7. https://doi.org/10.1093/rheumatology/keq310.

    Article  Google Scholar 

  23. Strickland G, Pauling J, Cavill C, McHugh N. Predictors of health-related quality of life and fatigue in systemic sclerosis: evaluation of the EuroQol-5D and FACIT-F assessment tools. Clin Rheumatol. 2012;31:1215–22. https://doi.org/10.1007/s10067-012-1997-1.

    Article  PubMed  Google Scholar 

  24. Prado GF, Allen RP, Trevisani VM, Toscano VG, Earley CJ. Sleep disruption in systemic sclerosis (scleroderma) patients: clinical and polysomnographic findings. Sleep Med. 2002;3:341–5.

    Article  Google Scholar 

  25. Frech T, Hays RD, Maranian P, Clements PJ, Furst DE, Khanna D. Prevalence and correlates of sleep disturbance in systemic sclerosis — results from the UCLA scleroderma quality of life study. Rheumatology (Oxford). 2011;50:1280–7. https://doi.org/10.1093/rheumatology/ker020.

    Article  Google Scholar 

  26. Basta F, Afeltra A, Margiotta DPE. Fatigue in systemic sclerosis: a systematic review. Clin Exp Rheumatol. 2018;36 Suppl 113(4):150–60.

    PubMed  Google Scholar 

  27. Maddali-Bongi S, Del Rosso A, Mikhaylova S, et al. Impact of hand and face disabilities on global disability and quality of life in systemic sclerosis patients. Clin Exp Rheumatol. 2014;32(6 Suppl 86):S-15-20.

    PubMed  Google Scholar 

  28. Frikha F, Masmoudi J, Saidi N, Bahloul Z. Sexual dysfunction in married women with systemic sclerosis. Pan Afr Med J. 2014;17:82. https://doi.org/10.11604/pamj.2014.17.82.3833.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Thombs BD, Bassel M, Mcguire L, Smith MT, Hudson M, Haythornthwaite JA. A systematic comparison of fatigue levels in systemic sclerosis with general population , cancer and rheumatic disease samples. Rheumatology. 2008;47:1559–63. https://doi.org/10.1093/rheumatology/ken331.

    Article  CAS  PubMed  Google Scholar 

  30. Assassi S, Leyva AL, Mayes MD, Sharif R, Nair DK. Predictors of fatigue severity in early systemic sclerosis: a prospective longitudinal study of the GENISOS cohort. PLoS One. 2011;6:e26061. https://doi.org/10.1371/journal.pone.0026061.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Chularojanamontri L, Sethabutra P, Kulthanan K, Manapajon A. Dermatology life quality index in Thai patients with systemic sclerosis: a cross-sectional study. Indian J Dermatol Venereol Leprol. 2011;77:683–7. https://doi.org/10.4103/0378-6323.86481.

    Article  PubMed  Google Scholar 

  32. Khanna D, Ahmed M, Furst DE, et al. Health values of patients with systemic sclerosis. 2007;57:86–93. https://doi.org/10.1002/art.22465.

  33. Del Rosso A, Boldrini M, D’Agostino D, et al. Health-related quality of life in systemic sclerosis as measured by the short form 36: relationship with clinical and biologic markers. Arthritis Rheum. 2004;51:475–81. https://doi.org/10.1002/art.20389.

    Article  PubMed  Google Scholar 

  34. Bodukam V, Hays RD, Maranian P, et al. Association of gastrointestinal involvement and depressive symptoms in patients with systemic sclerosis. Rheumatology (Oxford). 2011;50:330–4. https://doi.org/10.1093/rheumatology/keq296.

    Article  Google Scholar 

  35. Omair MA, Lee P. Effect of gastrointestinal manifestations on quality of life in 87 consecutive patients with systemic sclerosis. J Rheumatol. 2012;39:992–6. https://doi.org/10.3899/jrheum.110826.

    Article  PubMed  Google Scholar 

  36. Foocharoen C, Tyndall A, Hachulla E, et al. Erectile dysfunction is frequent in systemic sclerosis and associated with severe disease: a study of the EULAR scleroderma trial and research group. Arthritis Res Ther. 2012;14:R37. https://doi.org/10.1186/ar3748.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Sanchez K, Denys P, Giuliano F, et al. Systemic sclerosis: sexual dysfunction and lower urinary tract symptoms in 73 patients. Presse Med. 2016;45(4):e79–89. https://doi.org/10.1016/j.lpm.2015.08.009.

    Article  PubMed  Google Scholar 

  38. Benrud-Larson LM, Haythornthwaite JA, Heinberg LJ, et al. The impact of pain and symptoms of depression in scleroderma. Pain. 2002;95:267–75.

    Article  Google Scholar 

  39. Thombs BD, van Lankveld W, Bassel M, et al. Psychological health and Well-being in systemic sclerosis: state of the science and consensus research agenda. Arthritis Care Res. 2010;62:1181–9. https://doi.org/10.1002/acr.20187.

    Article  Google Scholar 

  40. Amin K, Sivakumar B, Clarke A, Puri A, Denton C, Butler PE. Hand disease in scleroderma: a clinical correlate for chronic hand transplant rejection. Springerplus. 2013;2:577. https://doi.org/10.1186/2193-1801-2-577.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Mohamed RH, Nassef AA. Brain magnetic resonance imaging findings in patients with systemic sclerosis. Int J Rheum Dis. 2010;13:61–7. https://doi.org/10.1111/j.1756-185X.2009.01453.x.

    Article  PubMed  Google Scholar 

  42. Bagnato G, Cordova F, Sciortino D, et al. Association between cortisol levels and pain threshold in systemic sclerosis and major depression. Rheumatol Int. 2018;38:433–41. https://doi.org/10.1007/s00296-017-3866-3.

    Article  CAS  PubMed  Google Scholar 

  43. Wipff J, Bonnet P, Ruiz B, et al. Association study of serotonin transporter gene (SLC6A4) in systemic sclerosis in European Caucasian populations. J Rheumatol. 2010;37:1164–7. https://doi.org/10.3899/jrheum.091156.

    Article  CAS  PubMed  Google Scholar 

  44. Malcarne VL, Greenbergs HL. Psychological adjustment to systemic sclerosis. Arthritis Care Res. 1996;9:51–9.

    Article  CAS  Google Scholar 

  45. Arat S, Verschueren P, De Langhe E, et al. The association of illness perceptions with physical and mental health in systemic sclerosis patients: an exploratory study. Musculoskelet Care. 2012;10:18–28. https://doi.org/10.1002/msc.223.

    Article  Google Scholar 

  46. Milette K, Thombs BD, Maiorino K, et al. Challenges and strategies for coping with scleroderma: implications for a scleroderma-specific self-management program. Disabil Rehabil. 2018;9:1–10. https://doi.org/10.1080/09638288.2018.1470263.

    Article  Google Scholar 

  47. Mura G, Bhat KM, Pisano A, Licci G, Carta M. Psychiatric symptoms and quality of life in systemic sclerosis. Clin Pract Epidemiol Ment Health. 2012;8:30–5. https://doi.org/10.2174/1745017901208010030.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. B. Shine Rheumatology Institute, Rambam Health Care Campus and The Rappaport Faculty of Medicine, Technion, Haifa, Israel

    Alexandra Balbir-Gurman & Yolanda Braun-Moscovici

Authors
  1. Alexandra Balbir-Gurman
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  2. Yolanda Braun-Moscovici
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Correspondence to Alexandra Balbir-Gurman .

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Editors and Affiliations

  1. University of Florence, Firenze, Firenze, Italy

    Marco Matucci-Cerinic

  2. University College London, Royal Free Hospital, London, UK

    Christopher P. Denton

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Balbir-Gurman, A., Braun-Moscovici, Y. (2021). Mood Problems and Depression in Systemic Sclerosis. In: Matucci-Cerinic, M., Denton, C.P. (eds) Practical Management of Systemic Sclerosis in Clinical Practice. In Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-53736-4_6

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  • DOI: https://doi.org/10.1007/978-3-030-53736-4_6

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