Psychosocial aspects of systemic sclerosis.
OBJECTIVE
In 2010, an international consortium of researchers published a consensus agenda for research on psychosocial aspects of systemic sclerosis (SSc; scleroderma). The present review summarizes recent research on SSc-related depression and anxiety, fatigue and sleep, pain, pruritus, body image distress, sexual function, work disability, healthcare needs, psychosocial interventions, and psychoneuroimmunology.


RESULTS
Researchers have used structured interviews to establish prevalence rates for clinical mood disorders in SSc, although anxiety remains understudied and distress may be a useful outcome to consider. Longitudinal research has identified predictors of fatigue. Research on body image distress suggests the importance of changes in the facial skin and hands. Studies have identified sexual function problems in women and men with SSc. A prospective study found that breathing problems and fatigue predicted workplace disability. A randomized controlled trial evaluating multidisciplinary care showed benefits for health-related quality of life.


CONCLUSIONS
There has been a recent expansion in studies of psychosocial aspects of SSc, and in the validation of psychosocial measures that can be used in clinics to identify problems and track outcomes; however, prospective studies remain scarce. To better address the psychosocial needs of persons with SSc, interventions need to be developed and tested via randomized controlled trials with power to detect clinically meaningful changes.
aDepartment of Psychology, San Diego State University bSDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, California, USA.
Vanessa L
VL
Malcarne
Rina S
RS
Fox
Sarah D
SD
Mills
Shadi
S
Gholizadeh
D057215:Body Dysmorphic Disorders / Q000209:etiology; D003863:Depression / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D006301:Health Services Needs and Demand; D006801:Humans; D001523:Mental Disorders / Q000209:etiology* / Q000628:therapy; D010146:Pain / Q000209:etiology; D011537:Pruritus / Q000209:etiology; D012595:Scleroderma, Systemic / Q000523:psychology* / Q000534:rehabilitation; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology; D012893:Sleep Wake Disorders / Q000209:etiology; D014938:Work Capacity Evaluation