Background Scleroderma is a systemic multiorgan autoimmune disease with high mortality and morbidity rates. In serious disease with organ manifestation, quality of life and perception of health is deeply influenced in these patients. The face changes and fibrosis of skin, digital ulceration contribute to the psychological trauma of these patients. Only little is known about the objective evaluation of systemic scleroderma psychological impact.
Objectives The aim of study is detection of psychological profile and manifestation of depression in scleroderma patients.
Methods From March 2015 to January 2016 we examined 42 patients with scleroderma Patients were evaluated by MMPI-II (The Minnesota Multiphasic Personality Inventory test, standardized psychometric test of adult personality and psychopathology) and BDI-II tests (Beck Depression Inventory test of depression). The data obtained from the multidimensional pachological testing were correlated with the clinical and laboratory pheonotype of the disease (smoking status, BMI, arterial hypertension, diabetes, lipid profile, family history of cardiovascular event, lung manifestation, pulmonary hypertension, digital ulceration, damage of gastrointestinal tract, myositis, renal crisis, autoantibody profile, and presence of cardiovascular events) Statistical tests (descriptive statistic, Student t-test, Spearman test, ANOVA) were performed and p-value ≤0.05 was considered as significant.
Results In this study42 patient were included (6 men, 36 women. mean of age – 57,8±9.4y., duration of disease 8,6±8.2y. duration of Raynauds phenomenon 13,4±11,2y.), 12 patient have diffuse form and 30 patient limited form of scleroderma. Subjective perceived depression detected by BDI II test was present in 16 patients (32.1%, mild 7, moderate 7 and 2 severe). BDI-II correlated with anticentromer antibodies (p=0.05), total cholesterol (p=0.008), LDL (p=0.05) and, gastrointestinal manifestation (p=0.002). Scale L, F and K in MMPI-II test in typical sequence for depressive score was detected in 38 patients (90%). The main scales of MMPI-II test were detected in followed percentage values: – Hypochondria (54.7%), Depression (33.3%), Converse hysteria (28.6%), Psychopathic (14.3%), Masculinity/Felinity (7.1%), Paranoia (9.5%), Psychastenia (26.2%), Schizophrenia (21.4%), Hypomania (11.9%) and Social introverse (33.3%).
Conclusions The limitation of these data is fact, that these tests showed some of trends of symptoms typical for psychological and personal manifestation; they could not be regarded as a diagnostic test. Patients with scleroderma have high prevalention of subjective perceived depression. In this study we detected high prevalence of depression, social introversion and trend toward somatisation. It will be very useful to be aware of this subjective perception of scleroderma patient and cooperated with psychologist or psychiatrist to improve quality of life and sometimes also morbidity of these seriously ill patients.
Acknowledgement Grant support: MZ CR VES15–28659A
Disclosure of Interest None declared