title: Sicca symptoms are associated with similar fatigue, anxiety, depression, and quality-of-life impairments in patients with and without primary Sjögren's syndrome.
abstract: OBJECTIVE
  To compare quality of life (QoL), depression, anxiety, and fatigue in prospectively included patients with primary Sjögren's syndrome (pSS) or with sicca but no diagnosis of Sjögren's syndrome.
  
  
  METHODS
  Patients undergoing a multidisciplinary evaluation at a single university center in Brest, France, for suspected pSS and having sicca symptoms were included prospectively between November 2006 and December 2013. The same standardized investigations were performed in all patients. pSS and sicca not due to pSS diagnoses were based on evaluating physician opinion. Each patient completed three validated questionnaires on QoL (SF-36), fatigue (MFI), depression and anxiety (HADS).
  
  
  RESULTS
  Of the 95 included patients, 55 (57.9%) had pSS and 40 (42.1%) had sicca without pSS. Gender distribution, age, disease duration, and sicca symptoms were similar in the two groups. The pSS group had a significantly higher proportion of patients with abnormal objective tests for dryness (Schirmer's test and salivary flow rate). The SF-36, HADS, and MFI scores were similarly altered in the two groups. Anxiety was more common than depression in both groups. The most affected domains were vitality in the SF-36 and general/physical fatigue in the MFI. Extraglandular systemic involvement was not a major determinant of QoL alteration in patients with pSS.
  
  
  CONCLUSIONS
  Sicca symptoms are associated with severe alterations in SF-36, HADS, and MFI scores regardless of objective test abnormalities and pSS diagnosis. Anxiety is more common than depression and should be taken into account when managing all patients with sicca symptoms.
authors.affiliation: Rheumatology Unit and Immunology Department (EA 2216), hôpital de la Cavale-Blanche, université Bretagne-Occidentale, CHU de Brest, BP 814, 29609 Brest cedex, France. Electronic address: morganemilin@hotmail.fr.
authors.forename: Morgane
authors.initials: M
authors.lastname: Milin
authors.affiliation: Rheumatology Unit and Immunology Department (EA 2216), hôpital de la Cavale-Blanche, université Bretagne-Occidentale, CHU de Brest, BP 814, 29609 Brest cedex, France.
authors.forename: Divi
authors.initials: D
authors.lastname: Cornec
authors.affiliation: Psychiatric Unit, université Bretagne-Occidentale, CHU de Brest, BP 814, 29609 Brest cedex, France.
authors.forename: Myriam
authors.initials: M
authors.lastname: Chastaing
authors.affiliation: Psychiatric Unit, université Bretagne-Occidentale, CHU de Brest, BP 814, 29609 Brest cedex, France.
authors.forename: Veronique
authors.initials: V
authors.lastname: Griner
authors.affiliation: Psychiatric Unit, université Bretagne-Occidentale, CHU de Brest, BP 814, 29609 Brest cedex, France.
authors.forename: Sofian
authors.initials: S
authors.lastname: Berrouiguet
authors.affiliation: Inserm CIC 0502, CHU de Brest, 29609 Brest cedex, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Nowak
authors.affiliation: Rheumatology Unit and Immunology Department (EA 2216), hôpital de la Cavale-Blanche, université Bretagne-Occidentale, CHU de Brest, BP 814, 29609 Brest cedex, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Marhadour
authors.affiliation: Rheumatology Unit and Immunology Department (EA 2216), hôpital de la Cavale-Blanche, université Bretagne-Occidentale, CHU de Brest, BP 814, 29609 Brest cedex, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Saraux
authors.affiliation: Rheumatology Unit and Immunology Department (EA 2216), hôpital de la Cavale-Blanche, université Bretagne-Occidentale, CHU de Brest, BP 814, 29609 Brest cedex, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Devauchelle-Pensec
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005221:Fatigue / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012016:Reference Values; D012720:Severity of Illness Index; D017678:Sex Distribution; D012859:Sjogren's Syndrome / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*
keywords: Quality of life; Sicca; Sjögren's syndrome