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A 38-Year-Old Woman with Elevated Muscle Enzymes, Raynaud’s Phenomenon, and Positive Anti-Topoisomerase I Antibody: Is She Depressed?

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Case Studies in Systemic Sclerosis

Abstract

Living with a chronic medical condition, such as systemic sclerosis (SSc), can negatively affect quality of life and psychological well-being. There is little research on outcomes important for quality of life in SSc, which poses significant challenges to addressing the psychosocial needs of people living with SSc. A recently published consensus statement highlighted important patient-reported outcomes associated with quality of life and well-being in SSc, including depression, fatigue, pain, pruritus (itching), body image distress, and sexual dysfunction. Given the wide range of problems and concerns faced by individuals with SSc, a broad approach to care, rather than an approach that focuses on a single disorder, such as depression, is recommended. Efforts are currently underway to develop strategies that focus on the behavioral and psychosocial aspects of SSc; however, in the meantime, models and approaches from fields such as psycho-oncology can be applied to support people living with SSc. For instance, care providers should be educated regarding problems faced by patients, and their supporters should facilitate discussions of these problems and should help patients in accessing self-help material. Rheumatologists and care providers should also develop relationships with competent mental health care professionals, in order to provide focused interventions and specialized care for patients in need.

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References

  1. 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;8:1181-1189.

    Article  Google Scholar 

  2. Haythornthwaite JA, Heinberg LJ, McGuire L. Psychologic factors in scleroderma. Rheum Dis Clin N Am. 2003;29:427-439.

    Article  Google Scholar 

  3. Evans DL, Charney DS, Lewis L, et al. Mood disorders in the medically ill: scientific review and recommendations. Biol Psychiatry. 2005;58:175-189.

    Article  PubMed  Google Scholar 

  4. Blazer DG, Kessler RC, McGonagle KA, Swartz MS. The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey. Am J Psychiatry. 1994;151:979-986.

    PubMed  CAS  Google Scholar 

  5. Pignone MP, Gaynes BN, Rushton JL, et al. Screening for depression in adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002;136:765-776.

    PubMed  Google Scholar 

  6. Baubet T, Ranque B, Taïeb O, et al. Mood and anxiety disorders in systemic sclerosis patients. Presse Méd. 2010;40(2):e111-e119.

    Article  PubMed  Google Scholar 

  7. Thombs BD, Taillefer SS, Hudson M, Baron M. Depression in patients with systemic sclerosis: a systematic review of the evidence. Arthritis Rheum. 2007;57:1089-1097.

    Article  PubMed  Google Scholar 

  8. Milette K, Hudson M, Baron M, Thombs BD, Canadian Scleroderma Research Group. Comparison of the PHQ-9 and CES-D depression scales in systemic sclerosis: internal consistency reliability, convergent validity, and clinical correlates. Rheumatology. 2010;49:789-796.

    Article  PubMed  Google Scholar 

  9. Thombs BD, Hudson M, Taillefer SS, Baron M, and the Canadian Scleroderma Research Group. Prevalence and clinical correlates of symptoms of depression in patients with systemic sclerosis. Arthritis Rheum. 2008;59:504-509.

    Article  PubMed  Google Scholar 

  10. Mozzetta A, Antinone V, Alfani S, et al. Mental health in patients with systemic sclerosis: a controlled investigation. J Eur Acad Dermatol Venereol. 2008;22:336-340.

    Article  PubMed  CAS  Google Scholar 

  11. Legendre C, Allanore Y, Ferrand I, Kahan A. Evaluation of depression and anxiety in patients with systemic sclerosis. Joint Bone Spine. 2005;72:408-411.

    Article  PubMed  Google Scholar 

  12. Angelopoulos NV, Drosos AA, Moutsopoulos HM. Psychiatric symptoms associated with scleroderma. Psychother Psychosom. 2001;70:145-150.

    Article  PubMed  CAS  Google Scholar 

  13. Van Lankveld WG, 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. 2007;46:872-876.

    Article  PubMed  Google Scholar 

  14. Swain MG. Fatigue in chronic disease. Clin Sci. 2000;99:1-8.

    Article  PubMed  CAS  Google Scholar 

  15. 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;47:1559-1563.

    Article  PubMed  CAS  Google Scholar 

  16. Hudson M, Steele R, Lu Y, Thombs BD, Baron M, Canadian Scleroderma Research Group. Work disability in systemic sclerosis. J Rheumatol. 2009;36:2481-2486.

    Article  PubMed  Google Scholar 

  17. Sandqvist G, Eklund M. Daily occupations–performance, satisfaction and time use, and relations with well-being in women with limited systemic sclerosis. Disabil Rehabil. 2008;30:27-35.

    Article  PubMed  Google Scholar 

  18. Sandqvist G, Scheja A, Eklund M. Working ability in relation to disease severity, everyday occupations and well-being in women with limited systemic sclerosis. Rheumatology. 2008;47:1708-1711.

    Article  PubMed  CAS  Google Scholar 

  19. Sandusky SB, McGuire L, Smith MT, Wigley FM, Haythornthwaite JA. Fatigue: an overlooked determinant of physical function in scleroderma. Rheumatology. 2009;48:165-169.

    Article  PubMed  CAS  Google Scholar 

  20. Thombs BD, Hudson M, Bassel M, Taillefer SS, Baron M, and the Canadian Scleroderma Research Group. Sociodemographic, disease, and symptom correlates of fatigue in systemic sclerosis: evidence from a sample of 659 Canadian Scleroderma Research Group Registry patients. Arthritis Rheum. 2009;61(7):966-973.

    Article  PubMed  Google Scholar 

  21. Benrud-Larson LM, Haythornthwaite JA, Heinberg LJ, et al. The impact of pain and symptoms of depression in scleroderma. Pain. 2002;95:267-275.

    Article  PubMed  Google Scholar 

  22. Danieli E, Airo P, Bettoni L, et al. 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. Clin Rheumatol. 2005;24:48-54.

    Article  PubMed  Google Scholar 

  23. Johnson SR, Glaman DD, Schentag CT, Lee P. Quality of life and functional status in systemic sclerosis compared to other rheumatic diseases. J Rheumatol. 2006;33:1117-1122.

    PubMed  Google Scholar 

  24. Schieir O, Thombs BD, Hudson M, et al. Prevalence, severity, and clinical correlates of pain in patients with systemic sclerosis. Arthritis Care Res. 2010;62:409-417.

    Article  Google Scholar 

  25. Weisshaar E, Kucenic MJ, Fleischer AB Jr. Pruritus: a review. Acta Derm Venereol Suppl. 2003;213:5-32.

    Google Scholar 

  26. Razykov I, Thombs BD, Hudson M, Bassel M, Baron M, and the Canadian Scleroderma Research Group. Prevalence and clinical correlates of pruritus in patients with systemic sclerosis. Arthritis Rheum. 2009;61:1765-1770.

    Article  PubMed  Google Scholar 

  27. El-Baalbaki G, Razykov I, Hudson M, et al. Association of pruritus with quality of life and disability in systemic sclerosis. Arthritis Care Res. 2010;62:1489-1495.

    Article  Google Scholar 

  28. Pruzinsky T. Social and psychological effects of major craniofacial deformity. Cleft Palate Craniofac J. 1992;29:578-584.

    Article  PubMed  CAS  Google Scholar 

  29. Malcarne VL, Handsdottir I, Greensbergs HL, Clements PJ, Weisman MH. Appearance self-esteem in systemic sclerosis. Cogn Ther Res. 1999;23:197-208.

    Article  Google Scholar 

  30. Jewett LR, Hudson M, Haythornthwaite JA, et al. Development and validation of the brief-satisfaction with appearance scale (Brief-SWAP) for systemic sclerosis (SSc). Arthritis Care Res. 2010;62(12):1779-1786.

    Article  Google Scholar 

  31. Jewett LR, Hudson M, Baron, M, Thombs BD, Canadian Scleroderma Research Group. Disentangling body image dissatisfaction and social discomfort in systemic sclerosis: a structural equation modeling approach (under review).

    Google Scholar 

  32. Bancroft J. Human Sexuality and Its Problems. 3rd ed. Edinburgh: Churchill Livingstone; 2009.

    Google Scholar 

  33. Schover LR, Jensen SR. Sexuality and Chronic Illness: A Comprehensive Approach. New York: Guilford Press; 1988.

    Google Scholar 

  34. Saad SC, Pietrzykowski JE, Lewis SS, et al. Vaginal lubrication in women with scleroderma and Sjögren’s syndrome. Sex Disabil. 1999;17:103-113.

    Article  Google Scholar 

  35. Saad SC, Behrend AE. Scleroderma and sexuality. J Sex Res. 1996;33:15-20.

    Article  Google Scholar 

  36. Knafo R, Thombs BD, Jewett L, Hudson M, Wigley F, Haythornthwaite JA. (Not) talking about sex: a systematic comparison of sexual impairment in women with systemic sclerosis and other chronic disease samples. Rheumatology. 2009;48:1300-1303.

    Article  PubMed  Google Scholar 

  37. Schouffoer AA, van der Marel J, ter Kuile MM, et al. Impaired sexual function in women with systemic sclerosis: a cross-sectional study. Arthritis Rheum. 2009;61:1601-1608.

    Article  PubMed  CAS  Google Scholar 

  38. Kowal-Bielecka O, Landewe R, Avouac J, et al. EULAR recommendations for the treatment of systemic sclerosis: a report from the EULAR scleroderma trials and research group (EUSTAR). Ann Rheum Dis. 2009;68:620-628.

    Article  PubMed  CAS  Google Scholar 

  39. Department of Health, Western Australia. Psycho-Oncology Model of Care. Perth: WA Cancer and Palliative Care Network, Department of Health, Western Australia; 2008.

    Google Scholar 

  40. Bilsker D, Samara J, Goldner E. Positive coping with health conditions: a self-care workbook. Consortium for Organizational Mental Healthcare (COMH); 2009.

    Google Scholar 

  41. Lorig KR, Sobel DS, Stewart AL, et al. Evidence suggesting that a chronic disease self-management program can improve health status while reducing utilization and costs: a randomized trial. Med Care. 1999;37:5-14.

    Article  PubMed  CAS  Google Scholar 

  42. Lorig K, Lubeck D, Kraines RG, Seleznick M, Holman HR. Outcomes of self-help education for patients with arthritis. Arthritis Rheum. 1985;28:680-685.

    Article  PubMed  CAS  Google Scholar 

  43. U.S. Preventive Services Task Force. Screening for depression in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;151:784-792.

    Google Scholar 

  44. Katon WJ, Seelig M. Population-based care of depression: team care approaches to improving outcomes. J Occup Environ Med. 2008;50:459-467.

    Article  PubMed  Google Scholar 

  45. National Institute for Health and Clinical Excellence (NICE). Antenatal and Postnatal Mental Health: The NICE Guideline on Clinical Management and Service Guidance. UK: NICE; 2007.

    Google Scholar 

  46. Ziegelstein RC, Thombs BD, Coyne JC, de Jonge P. Routine screening for depression in patients with coronary heart disease: never mind. J Am Coll Cardiol. 2009;54:886-890.

    Article  PubMed  Google Scholar 

  47. Thombs BD, Jewett LR, Knafo R, Coyne JC, Ziegelstein RC. Learning from history: a commentary on the American Heart Association Science Advisory on depression screening. Am Heart J. 2009;158:503-505.

    Article  PubMed  Google Scholar 

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Acknowledgments

Ms. Jewett was supported by a Bourses de Formation – Formation de Maîtrise from the Fonds de la recherche en santé Québec. Drs. Thombs and Hudson are supported by New Investigator Awards from the Canadian Institutes of Health Research and Établissement de Jeunes Chercheurs awards from the Fonds de la Recherche en Santé Québec.

Author information

Authors and Affiliations

  1. Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC, H3T 1E4, Canada

    Brett D. Thombs

  2. Department of Psychiatry, McGill University & Lady Davis Institute of Medical Research of Jewish General Hospital, Montreal, QC, Canada

    Lisa R. Jewett B.A.

  3. Department of Medicine, McGill University & Lady Davis Institute of Medical Research of Jewish General Hospital, Montreal, QC, Canada

    Marie Hudson M.D., MPH.

Authors
  1. Lisa R. Jewett B.A.
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  2. Marie Hudson M.D., MPH.
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  3. Brett D. Thombs
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Editors and Affiliations

  1. , Division of Rheumatology & Immunology, Medical University of South Carolina, Charleston, 29403, USA

    Richard M. Silver

  2. Royal Free and University College, Medical School, University College London, Rowland Street, London, NW3 2PF, United Kingdom

    Christopher P. Denton

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Jewett, L.R., Hudson, M., Thombs, B.D. (2011). A 38-Year-Old Woman with Elevated Muscle Enzymes, Raynaud’s Phenomenon, and Positive Anti-Topoisomerase I Antibody: Is She Depressed?. In: Silver, R., Denton, C. (eds) Case Studies in Systemic Sclerosis. Springer, London. https://doi.org/10.1007/978-0-85729-641-2_24

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  • DOI: https://doi.org/10.1007/978-0-85729-641-2_24

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  • Print ISBN: 978-0-85729-640-5

  • Online ISBN: 978-0-85729-641-2

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