title: Correlates of depression, including overall and gastrointestinal functional status, among patients with systemic sclerosis.
abstract: 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 Epidemiologic 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Biostatistics, Bioinformatics, and Epidemiology, Center for Health Care Research, Medical University of South Carolina, Charleston, South Carolina, USA. nieterpj@musc.edu
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Nietert
authors.forename: Holly C
authors.initials: HC
authors.lastname: Mitchell
authors.forename: Marcy B
authors.initials: MB
authors.lastname: Bolster
authors.forename: Margaret Y
authors.initials: MY
authors.lastname: Curran
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Tilley
authors.forename: Richard M
authors.initials: RM
authors.lastname: Silver
mesh_terms: D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000523:psychology; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D006304:Health Status; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012595:Scleroderma, Systemic / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires