title: Pruritus is associated with severely impaired quality of life in patients with primary sclerosing cholangitis.
abstract: OBJECTIVE
  Quality of life, fundamental to the individual patient, has shown a lack of correlation with severity in research on several diseases. Thus, we aimed to identify factors associated with quality of life in patients with primary sclerosing cholangitis.
  
  
  METHODS
  The Short Form Health Survey and the Patient Health Questionnaire were used to assess quality of life and depression. Complete data sets of 113 patients were analyzed for correlation with sex, age, presence of concomitant inflammatory bowel disease and dominant stenosis, frequency of pruritus, and Mayo Risk Score.
  
  
  RESULTS
  Physical functioning decreased with age (P<0.001). Further, women experienced more prominent role limitations because of physical (P<0.03) and emotional (P<0.01) problems. Although patients' quality of life and depression scores were only slightly lower than normal, more frequent pruritus was associated with a considerable reduction in quality of life in terms of physical and social functioning, general and mental health, bodily pain, vitality, and roles (because of physical problems) (P<0.01). It did not differ significantly according to the Mayo Risk Score or the presence of dominant stenoses. Depression scores were only significantly affected in patients with more frequent pruritus.
  
  
  CONCLUSIONS
  Pruritus severely affects quality of life in patients with primary sclerosing cholangitis and is associated with depression to varying extents, although the most commonly used parameters of disease severity do not correspond to quality of life in these patients. These findings need to be considered with respect to treatment outcomes and indications for liver transplantation.
authors.affiliation: Departments of aInternal Medicine IV bInternal Medicine II, University Hospital of Heidelberg, Heidelberg cDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Daniel Nils
authors.initials: DN
authors.lastname: Gotthardt
authors.forename: Christian
authors.initials: C
authors.lastname: Rupp
authors.forename: Miriam
authors.initials: M
authors.lastname: Bruhin
authors.forename: Dieter
authors.initials: D
authors.lastname: Schellberg
authors.forename: Karl H
authors.initials: KH
authors.lastname: Weiss
authors.forename: Reinhard
authors.initials: R
authors.lastname: Stefan
authors.forename: Nadine
authors.initials: N
authors.lastname: Donnerstag
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Stremmel
authors.forename: Bernd
authors.initials: B
authors.lastname: Löwe
authors.forename: Jana
authors.initials: J
authors.lastname: Juenger
authors.forename: Peter
authors.initials: P
authors.lastname: Sauer
mesh_terms: D000328:Adult; D000367:Age Factors; D015209:Cholangitis, Sclerosing / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011537:Pruritus / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires