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Stress, coping strategies and social support in patients with primary Sjogren's syndrome prior to disease onset: a retrospective case control study
  1. Dimitris Karaiskos
  1. Department of Pathophysiology, University of Athens School of Medicine, Athens, Greece
    1. Clio P Mavragani (mavraganik{at}hss.edu)
    1. Hospital for Special Surgery, New York, United States
      1. Sotiria Makaroni
      1. Department of Pathophysiology, University of Athens School of Medicine, Athens, Greece
        1. Elias Zinzaras
        1. Department of Biomathematics, University of Thessaly School of Medicine, Larissa, Greece
          1. Michael Voulgarelis
          1. Department of Pathophysiology, University of Athens School of Medicine, Athens, Greece
            1. Andreas Rabavilas
            1. Department of Psychiatry, University of Athens School of Medicine, and University Mental Health Res, Greece
              1. Haralampos M Moutsopoulos (hmoutsop{at}med.uoa.gr)
              1. Department of Pathophysiology, University of Athens School of Medicine, Athens, Greece

                Abstract

                Objectives: Prior evidence suggests the role of psychological stress in triggering the onset of autoimmunity. We aimed to investigate whether stress following major and minor life events could precede the onset of primary Sjogren’s syndrome (pSS). The role of coping strategies and social support, as compensating buffering mechanisms, was also explored.

                Methods: 47 pSS patients were compared with two control groups: 35 lymphoma patients (DC) and 120 healthy controls (HC) with disease onset within the previous year. All subjects completed questionnaires assessing the occurrence of major and minor stressful events, coping strategies and social support prior to disease onset. Data analysis was performed by univariate and multivariate logistic regression models.

                Results: A higher number of pSS patients reported the occurrence of negative stressful life events prior to disease onset compared to lymphoma patients and HC, while the number and impact of daily hassles did not differ between the three groups. Coping strategies were defective and the overall social support was lower in pSS patients compared to DC and HC groups. In the multivariate model, pSS status was associated with maladaptive coping and lower overall social support relative to DC and HC as well as with increased number of negative stressful life events compared to HC but not DC.

                Conclusion: Prior to disease onset, pSS patients experience high psychological stress following major negative life events, without developing satisfactory adaptive coping strategies to confront their stressful life changes. Lack of social support may contribute to the relative risk of disease development.

                • Sjögren's syndrome
                • coping strategies
                • lymphoma
                • social support
                • stressful life events

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