title: Clinical, functional and health-related quality of life correlates of clinically significant symptoms of anxiety and depression in patients with systemic sclerosis: a cross-sectional survey.
abstract: OBJECTIVE
  To identify clinical, functional and health-related quality of life (HRQoL) correlates of clinically significant symptoms of anxiety and depression in patients with systemic sclerosis (SSc).
  
  
  METHODS
  Three-hundred-and-eighty-one patients fulfilling the American College of Rheumatology and/or the Leroy and Medsger criteria for SSc were assessed for visceral involvement, disability and HRQoL (assessed by SF-36). Clinically significant symptoms of anxiety and depression were evaluated with the Hospital Anxiety Depression Scale (HAD) (defined cut-off≥8).
  
  
  RESULTS
  9.2% the patients had limited SSc, 50.5% limited cutaneous SSc (lcSSc), and 40.3% diffuse cutaneous SSc (dcSSc). Overall, 40.4% and 58.8% of the patients had clinically significant symptoms of depression and anxiety, respectively. Compared to patients without clinically significant symptoms of depression, patients with clinically significant symptoms of depression had poorer health status, HRQoL mental and physical component, and greater global disability, hand disability and aesthetic impairment. Compared to patients without clinically significant symptoms of anxiety, patients with clinically significant symptoms of anxiety had poorer SF-36 mental and physical component scores. On multivariable analysis, excluding mental component score of SF-36, variables independently associated with clinically significant symptoms of depression and anxiety were global disability and physical component of SF-36, plus female gender for clinically significant symptoms of anxiety only. Remarkably, patients with and without clinically significant psychiatric symptoms were comparable for all disease-related clinical features assessed.
  
  
  CONCLUSIONS
  High levels of clinically significant symptoms of anxiety and depression are observed among SSc patients. Clinically significant psychiatric symptoms are rather associated with increased disability and altered HRQoL, than with disease-specific organ manifestations.
authors.affiliation: Pôle de Médecine Interne, Centre de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, Hôpital Cochin, Faculté de Médecine Paris Descartes, Université Paris Descartes & Assistance Publique-Hôpitaux de Paris, Paris, France ; Service de Médecine Physique et Réadaptation, Hôpital Cochin, Faculté de Médecine Paris Descartes, Université Paris Descartes & Assistance Publique-Hôpitaux de Paris, INSERM, Institut Fédératif de Recherche sur le Handicap, Paris, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Nguyen
authors.affiliation: Service de Médecine Interne, Hôpital Européen Georges Pompidou, Faculté de Médecine Paris Descartes, Université Paris Descartes & Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Ranque
authors.affiliation: Service de Psychopathologie, Hôpital d'Avicenne, EA 3413, Université Paris XIII & Assistance Publique-Hôpitaux de Paris, Bobigny, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Baubet
authors.affiliation: Pôle de Médecine Interne, Centre de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, Hôpital Cochin, Faculté de Médecine Paris Descartes, Université Paris Descartes & Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Bérezné
authors.affiliation: Pôle de Médecine Interne, Centre de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, Hôpital Cochin, Faculté de Médecine Paris Descartes, Université Paris Descartes & Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Mestre-Stanislas
authors.affiliation: Service de Médecine Physique et Réadaptation, Hôpital Cochin, Faculté de Médecine Paris Descartes, Université Paris Descartes & Assistance Publique-Hôpitaux de Paris, INSERM, Institut Fédératif de Recherche sur le Handicap, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Rannou
authors.affiliation: Service de Médecine Physique et Réadaptation, Hôpital Cochin, Faculté de Médecine Paris Descartes, Université Paris Descartes & Assistance Publique-Hôpitaux de Paris, INSERM, Institut Fédératif de Recherche sur le Handicap, Paris, France.
authors.forename: Agathe
authors.initials: A
authors.lastname: Papelard
authors.affiliation: Service de Médecine Interne, Centre de Référence pour la Sclérodermie Systémique, Hôpital Claude Huriez, Université Lille 2, Lille, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Morell-Dubois
authors.affiliation: Service de Médecine Physique et Réadaptation, Hôpital Cochin, Faculté de Médecine Paris Descartes, Université Paris Descartes & Assistance Publique-Hôpitaux de Paris, INSERM, Institut Fédératif de Recherche sur le Handicap, Paris, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Revel
authors.affiliation: Service de Psychopathologie de l'Adolescent, Hôpital Cochin, Faculté de Médecine Paris Descartes, Université Paris Descartes & Assistance Publique-Hôpitaux de Paris, INSERM U669, Paris, France.
authors.forename: Marie-Rose
authors.initials: MR
authors.lastname: Moro
authors.affiliation: Pôle de Médecine Interne, Centre de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, Hôpital Cochin, Faculté de Médecine Paris Descartes, Université Paris Descartes & Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Loïc
authors.initials: L
authors.lastname: Guillevin
authors.affiliation: Service de Médecine Physique et Réadaptation, Hôpital Cochin, Faculté de Médecine Paris Descartes, Université Paris Descartes & Assistance Publique-Hôpitaux de Paris, INSERM, Institut Fédératif de Recherche sur le Handicap, Paris, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Poiraudeau
authors.affiliation: Pôle de Médecine Interne, Centre de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, Hôpital Cochin, Faculté de Médecine Paris Descartes, Université Paris Descartes & Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Mouthon
mesh_terms: D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D006306:Health Surveys / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012595:Scleroderma, Systemic / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires