Background There is high prevalence of mood disorders in patients with systemic scleroderma. Psychical distress can influent some of clinical manifestations and can worse the course of the disease and socioeconomicall status of patients.
Objectives The aim of study is detection of correlations of depression and psychological profile measures by MMPI-II (The Minnesota Multiphasic Personality Inventory) and BDI-II (The Beck Depression Inventory-II) and organ manifestation and immunological profile of patients with systemic sclerosis.
Methods From March 2015 to July 2017 we examined 42 patients with scleroderma, from which 37 filled the valorisation criteria of MMPI-II test. The data of MMPI-II scales and BDI-II was correlated with antropometric data, form of disease, disease duration, duration of RP, organ major manifestation, comorbidities, use of medication and immunological profile.
Results In this study 37 patient were included (6 men, 31 women, mean of age – 58.8±10.6y., duration of disease 8,9±9.1y, duration of RP 13.9±13.4y.), 10 patient have diffuse, 27 patient limited form. Subjective perceived depression detected by BDI II test was present in 11 patients (35%, mild 6, moderate 3 and 2 severe). Total BDI-II score correlated with anticentromer Abs (p=0.05), total cholesterol (p=0.008), LDL (p=0.05) and gastrointestinal manifestation (p=0.002). Positivity in domain - Hypochondria, Depression, Hysteria, Psychastenia and Social introversion was highly prevalent (47–13%). This results of MMPI-II suggest a specific psychological profile of SSc patients. There was no correlation for age, subset of disease, cardiovascular manifestation, valvular damage and myositis. Smokers are much more introvert (p=0.012). Positivity of anti Scl70 Ab correlated with incredulity (p=0.038), schizophrenia, hypomania and family disharmony (p=0.046). Positivity of anticentromer antibodies was connected with incredulity (p=0.038), hypomania, alienation to family, egocentrism (p=0.042), psychotic thinking, psychomotoric retardation (p=0.037) and subscales of BDI-II test (Loss of pleasure, Self-Criticism, Self-Dislike). From organ manifestation, pulmonary hypertension correlated with himself degradation (p=0.037). Gastrointestinal manifestation has the same correlation and BDI-II subscale-Guilt Feelings (p=0.042). It is interesting, that absence of lung damage demonstrated with alienation self and family (p=0.049), posttraumatic stress disorder (p=0.025), problems in family (in more scales, p=0.028,0.03,0.029), schizophrenia (p=0.03). Patients without digital ulceration have much more neurologic symptoms (p=0.023). Using of antidepressant and anxiolitic medication correlated with a lot of scales in domain of depression, anxiety, social introversion, family distress and self devaluation. Disease duration and duration of RP correlated with psychomotoric retardation.
Conclusions Patients with scleroderma may have special psychological profile. MMPI-II test shows specific psychologic abnormalities of scleroderma patients. Psychiatric and psychologic intervention can be very useful in complex care of these patients.
Acknowledgements MZ CR VES15–28659A.
Disclosure of Interest None declared