SAN ANTONIO — The current and lifetime prevalence of major depression is high among patients with scleroderma, an underrecognized fact that can no longer be ignored, Thierry Baubet, M.D., said at the annual meeting of the American College of Rheumatology.
Among 94 patients with systemic sclerosis seen in two French medical centers between May 2002 and May 2004, 17 (18%) had a current diagnosis of major depression, 50 (53%) had a lifetime diagnosis of major depression, and 7 (7%) had a current diagnosis of dysthymia. Moreover, 12 had a history of suicide attempts, and 31 were judged to have a moderate to severe ongoing suicide risk, he said.
The patients ranged in age from 26 to 85 years, and 81 were women. Psychiatric assessment was done using the Mini-International Neuropsychiatric Interview, the French DSM-IV, the 13-item Beck depression inventory, and the hospital anxiety and depression scale.
Additional information regarding past and current psychiatric treatment was sought with a structured questionnaire.
Fewer than half of patients with affective disorders had received psychiatric treatment, said Dr. Baubet of the psychiatric service, Avicenne Hospital, Bobigny (France).
Anxiety disorders also were common in this cohort, being diagnosed in 35 patients. Social phobia and generalized anxiety each were diagnosed in 13 patients, agoraphobia without panic disorder was diagnosed in 9, panic disorder in 6, posttraumatic stress disorder in 2, and obsessive compulsive disorder in 1. Some patients had more than one anxiety diagnosis.
Depression and anxiety are common and frequently overlooked in patients with systemic sclerosis, Dr. Baubet said in a poster session.
“Systematic screening and psychiatric treatment interventions are needed,” he said.
