title: Impact of pain in health related quality of life of patients with systemic sclerosis.
abstract: OBJECTIVE
  Systemic sclerosis (SSc) has an heterogenous clinical pattern, with variable organ involvement and degrees of severity. Like in other rheumatic diseases, the self-questionnaires have been used to evaluate SSc globally. The aim of the study is as to evaluate the quality of life (QoL) in patients with either diffuse or limited SSc, and to examine the impact of pain on the QoL scores.
  
  
  METHODS
  Patients with SSc, either diffuse or limited SSc, were included in a cross-sectional study. The QoL was evaluated with the short-form 36 (SF-36) and the functional repercussion with the SSc-modified Health Assessment Questionnaire (S-HAQ).
  
  
  RESULTS
  A total of 89 patients (67 with diffuse and 22 with limited SSc) were included. The SF-36 score values were lower in SSc patients than those reported in the general population. The physical component scores (PCS) of the SF-36 was significantly worse in diffuse compared with limited SSc (P < 0.05). The PCS was significantly negatively related to the number of clinical manifestations (ANOVA, P < 0.0001). The mental component score (MCS) was not influenced by the type of SSc or the number of clinical manifestations presented by the patient. The QoL of SSc patients was highly correlated with pain (R = 0.69) and disability (R = 0.70). Interestingly, the QoL of SSc patients was only slightly correlated with cutaneous (R = 0.42) and pulmonary involvement (R = 0.57).
  
  
  CONCLUSIONS
  The QoL of patients with SSc is strongly influenced by the type of SSc, the burden of clinical manifestations, the functional disability and by the pain, whatever its cause. The treatment of pain should be considered as priority to improve the QoL of SSc patients.
authors.affiliation: Internal Medicine Department, Saint Louis Hospital, Service de Médecine Interne, Hôpital Saint Louis, 1 avenue Claude Vellefaux, 75010 Paris, France. claire.georges@sls.aphp.fr
authors.forename: C
authors.initials: C
authors.lastname: Georges
authors.forename: O
authors.initials: O
authors.lastname: Chassany
authors.forename: C
authors.initials: C
authors.lastname: Toledano
authors.forename: L
authors.initials: L
authors.lastname: Mouthon
authors.forename: K
authors.initials: K
authors.lastname: Tiev
authors.forename: O
authors.initials: O
authors.lastname: Meyer
authors.forename: D
authors.initials: D
authors.lastname: Ilie
authors.forename: J
authors.initials: J
authors.lastname: Rambeloarisoa
authors.forename: Z
authors.initials: Z
authors.lastname: Marjanovic
authors.forename: J
authors.initials: J
authors.lastname: Cabane
authors.forename: D
authors.initials: D
authors.lastname: Sereni
authors.forename: J
authors.initials: J
authors.lastname: Pouchot
authors.forename: D
authors.initials: D
authors.lastname: Farge
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology / Q000523:psychology; D008171:Lung Diseases / Q000209:etiology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000523:psychology*; D011788:Quality of Life; D012595:Scleroderma, Systemic / Q000150:complications / Q000523:psychology*; D012871:Skin Diseases / Q000209:etiology / Q000523:psychology; D013272:Stomach Diseases / Q000209:etiology / Q000523:psychology