title: Mental health in patients with systemic sclerosis: a controlled investigation.
abstract: BACKGROUND
  Despite the undeniable impact of systemic sclerosis (SS) on quality of life, only a few studies so far have focused on its psychiatric or psychological aspects. We aimed at assessing psychiatric symptoms and self-image in inpatients with SS and comparing them with patients with either a very mild skin condition or a serious skin condition.
  
  
  METHODS
  Three groups were recruited: (i) 38 consecutive female inpatients with SS; (ii) 38 age-matched female outpatients with melanocytic naevi; (iii) 35 age-matched female inpatients with melanoma. All participants completed the Zung Anxiety Scale, the Zung Depression Scale and a self-report questionnaire measuring self-perceived personal qualities. Patients with SS were also clinically interviewed by a psychologist.
  
  
  RESULTS
  The clinical interview revealed the presence of a psychiatric disorder in most (81%) patients with SS. The Zung scales corroborated the presence of mild to moderate anxiety and depression among patients with SS, who scored significantly higher than patients with either naevi or melanoma on both scales. Scores on the questionnaire assessing self-perceived personal qualities were very similar in the three groups and indicated a fairly high level of self-esteem.
  
  
  CONCLUSIONS
  This study suggested that psychosocial issues are quite relevant in patients with SS and underscored the need for a biopsychosocial approach to the clinical management of these patients. Timely detection of psychosocial difficulties and appropriate psychological or psychiatric intervention may represent important steps toward better adherence to medical treatment and improved psychological well-being and quality of life.
authors.affiliation: Clinical Psychology and Psychosomatic Psychotherapy Unit, Dermopathic Institute of the Immaculate IDI-IRCCS, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mozzetta
authors.forename: V
authors.initials: V
authors.lastname: Antinone
authors.forename: S
authors.initials: S
authors.lastname: Alfani
authors.forename: P
authors.initials: P
authors.lastname: Neri
authors.forename: P G
authors.initials: PG
authors.lastname: Foglio Bonda
authors.forename: P
authors.initials: P
authors.lastname: Pasquini
authors.forename: P
authors.initials: P
authors.lastname: Puddu
authors.forename: A
authors.initials: A
authors.lastname: Picardi
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D016022:Case-Control Studies; D003863:Depression / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008545:Melanoma / Q000523:psychology*; D008603:Mental Health; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012595:Scleroderma, Systemic / Q000523:psychology*; D012649:Self Concept; D012878:Skin Neoplasms / Q000523:psychology*