Correlates of depression, including overall and gastrointestinal functional status, among patients with systemic sclerosis
Nietert, P.J.; Mitchell, H.C.; Bolster, M.B.; Curran, M.Y.; Tilley, B.C.; Silver, R.M.
Journal of Rheumatology 32(1): 51-57
2005
ISSN/ISBN: 0315-162X PMID: 15630725 Document Number: 593446
Objective. Patients with systemic sclerosis (SSc) may develop psychological problems in addition to physiologic symptoms. We investigated whether demographic and clinical factors are associated with comorbid depression. Methods. From a university hospital's rheumatology clinic, 72 SSc patients who completed 3 questionnaires (Center for Epidermiologic Studies Depression (CES-D) scale, an abbreviated version of a functional status instrument, the Scleroderma Health Assessment Questionnaire (SHAQ), and the Gastrointestinal Quality of Life Index (GIQLI)) during an examination were recruited into the study. Correlations among scores on the 3 questionnaires (including upper and lower gastrointestinal (GI) tract subscales of the GIQLI) were calculated, and associations between CES-D scores and a variety of demographic and clinical characteristics were-examined using stepwise linear regression. Results. Higher CES-D scores (i.e., more depression symptoms) were significantly correlated with upper (r = -0.48, p < 0.0001) and lower (r = -0.41, p < 0.001) GI tract dysfunction and worse overall functional status (r = 0.51, p < 0.0001). Stepwise regression indicated that higher levels of depression were independently associated with lower levels of education (p < 0.01), worse upper GI tract functioning (p = 0.019), worse functional status (p = 0.34), current corticosteroid use (p = 0.061), and cardiac involvement (p = 0.086). Conclusion. Decreased functional status and abnormal GI functioning are significantly correlated with depression among patients with SSc. Other demographic and clinical indicators are also associated with depression.