Mood and anxiety disorders in systemic sclerosis patients.
OBJECTIVE
To assess the prevalence of mood and anxiety disorders in systemic sclerosis (SSc) patients and the association of these disorders with clinical features.


METHODS
Between May 2002 and May 2004, 100 SSc patients fulfilling the American Rheumatism Association and/or Leroy & Medsger criteria were recruited: 51 were from a SSc patient association meeting, and 49 were hospitalized in an internal medicine department and recruited consecutively. Mood and anxiety disorders were assessed by use of a structured clinical interview [the Mini International Neuropsychiatric Interview (MINI)] performed by a psychiatrist and a self-reporting questionnaire [the Hospital Anxiety and Depression Scale (HADS)]. On the same day, psychiatric treatment and clinical features were recorded by a physician.


RESULTS
As assessed by the MINI, 19% [95% confidence interval 12-28%] of all SSc patients were currently experiencing a major depressive episode (MDE), 56% [46-65%] had a lifetime history of MDE and 14% [8-22%] had current dysthymia. Current MDE was more prevalent among hospitalized patients than among other patients (28% versus 10%, p=0.02). Specific anxiety disorders were diagnosed in 37 [28-47] patients. Less than 50% of the patients with mood disorders received psychiatric treatment. Patients with or without current depression did not differ in clinical symptoms of SSc, except for digestive symptoms.


CONCLUSIONS
The current and lifetime prevalence of major depression and anxiety disorders is high in SSc patients, especially during hospitalization. However, only half of such patients receive adequate psychiatric treatment. Therefore, a better assessment of psychiatric disorders in SSc patients is needed.
Université de Paris 13, Assistance publique-Hôpitaux de Paris (AP-HP), hôpital Avicenne, service de psychopathologie, EA 3413, 93009 Bobigny cedex, France.
Thierry
T
Baubet
Brigitte
B
Ranque
Olivier
O
Taïeb
Alice
A
Bérezné
Olivier
O
Bricou
Salim
S
Mehallel
Christine
C
Moroni
Catherine
C
Belin
Christian
C
Pagnoux
Marie-Rose
MR
Moro
Loïc
L
Guillevin
Luc
L
Mouthon
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D011788:Quality of Life; D012595:Scleroderma, Systemic / Q000150:complications*