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J Rheumatol. 2003 Aug;30(8):1782-7.

Frequency and analysis of factors closely associated with the development of depressive symptoms in patients with scleroderma.

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Graduate School of Medical Science, Saga Medical School, Saga, Japan.



To examine the frequency of depressive symptoms and also to identify factors closely associated with their development in patients with scleroderma (systemic sclerosis, SSc).


We evaluated 50 patients with SSc for factors associated with depressive symptoms using the following established scales: the Beck Depression Inventory (BDI); the Rheumatology Attitude Index for measuring helplessness; the Sense of Coherence (SOC) scale (a measure of an individual's resilience in the face of stress and capacity to cope with it); the modified Health Assessment Questionnaire for physical disability, working, and social function; support domains of Arthritis Impact Measurement Scales version 2; and a visual analog pain scale. In addition, disease severity of SSc, including skin thickness and internal organ involvement, was also examined in each patient. Multiple regression analysis was used to determine which factors correlated with depressive symptoms.


Depressive symptoms ranging from mild to severe state were seen in 46% of the patients. Total BDI scores were significantly correlated with low working ability, low social activity, low SOC, pain, and helplessness, and not associated with disease severity variables including skin score and internal organ involvement. Multiple regression analysis showed that a high level of helplessness and a low level of SOC might be closely associated with depressive symptoms in SSc.


Our results indicate that depressive symptoms are frequent in SSc patients. Medical staffs should pay attention to the possible risk factors for depressive symptoms, such as patient's helplessness and SOC.

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