Background Several risk factors, such as genetic, infections, sexual hormones and stress, have been frequently considered in the pathogenesis of autoimmune diseases. Stress has nowadays gained more attention, as it is able to influence the close relationships existing between hypothalamic-pituitary-adrenal (HPA) axis, sympathetic nervous system and immune system. The stress response results in the release of neurotransmitters (norepinephrine), hormones (cortisol) and immune cells which serve to send an efferent message from the brain to the periphery (1).
Objectives Our aim was to investigate for the presence of acute stressful events in a cohort of Systemic Sclerosis (SSc) patients referring to our out-patient clinic. We investigated for events occurring before the onset of the disease symptoms.
Methods We reported for any acute stress events preexisting the onset of the disease symptoms since six months before, collecting these data from the medical history of 70 SSc patients. Thus we fulfilled the Psychosocial Stress Severity Scale of DSM III-R for adults (Tab. 1) (2).
Results We evaluated 64 women and 6 men, mean age 61 years; 44 had a limited cutaneous SSc, 26 had a diffuse form. Forty patients (57%) had an acute stressing event in their medical history, before the disease onset. Among these 40 SSc patients, 2 of them reported a catastrophic event, 18 an extreme event, 5 a severe event, 10 a moderate event, 5 a mild event (Table 1).
Conclusions Our preliminary results point out a high prevalence of acute stressful events, preceding the disease onset, in SSc. These results straighten the importance of acute stress in autoimmune conditions. Further investigations focusing on persistent chronic stressful events are needed to better define their possible role in the pathogenesis of this disease.
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Frances et al: Diagnostic and statistical manual of mental disorders. American Psychiatric Association 1987.
Disclosure of Interest None declared