Depression is prevalent among individuals with systemic sclerosis (SSc), according to a study recently published in the Journal of Affective Disorders. This underscores the need for a screening approach and program for care among those with the condition.
This nationwide study included 15,141 individuals, 2431 of whom had SSc and 12,710 of whom were controls. Depression was more common among those with SSc (16.2%; n=395) than among controls (10.9%; n=1389), a difference that was more pronounced among women and those of lower socioeconomic status. System sclerosis was identified using multivariate logistic regression as an independent risk factor for depression (odds ratio, 1.55; 95% CI, 1.29-1.88; P <0001). Autoantibodies specific to SSc, including anti-Scl-70, anti-RNA polymerase III, anti-RNP, and anti-centromere, were not associated with depression risk. The effect of depression on mortality was not significant (hazard ratio, 1.06; 95% CI, 0.80-1.42).
The age of participants in this study was 63.32±18.06 years, and the sample was 81.7% female. Age at baseline and diagnosis, smoking status, and gender were similar between cases and controls (P >.05 for all). The 2 groups did differ in terms of both BMI (P <.0001) and socioeconomic status (P <.0001). Researchers performed univariate analysis using t-tests and chi-squared tests, and they conducted multivariate analysis using logistic regression. They also used Kaplan-Meier curves to analyze survival, while multivariate Cox proportional hazards were used to identify factors linked with all-cause mortality risk.
The study researchers conclude that “a relevant percentage of [patients with SSc] have to cope with a range of psychosocial problems, including depression, and may benefit from a screening approach and a broad supportive care program. Moreover, SSc-linked autoantibodies were not associated with an increased risk [for] depression, supporting that depression may be prevalent also in less severe SSc disease forms. Understanding the underlying pathogenic pathways leading to depression in patients with SSc may facilitate coping with their mental illness at an earlier phase of the disease and prevent so grim outcomes.”
Bragazzi NL, Watad A, Gizunterman A, et al. The burden of depression in systemic sclerosis patients: a nationwide population-based study [published online September 21, 2018]. J Affect Disord. doi:10.1016/j.jad.2018.09.075