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Sarcoidosis is a systemic granulomatous disease. At present, the issue of etiology of the disease has not yet been answered. The treatment of choice is corticosteroid therapy; new trends include biological treatment. Stress and overload often occur in the early stages, and depression and anxiety are added during the course of the disease. 50-70% of patients complain of fatigue, which affects the quality of their life even after the disappearance of other symptoms. Cognitive Behavioral Therapy (CBT) is recommended as the most suitable therapy for fatigue-it affects the anxiety and symptoms of depression and thus indirectly affects the fatigue (25, 27). In our work, we used group CBT to influence fatigue. Group therapy lasted for 6 weeks. We set up a group of 14 patients who complained of fatigue during the reporting period. Patients completed the BDI-II and FAS questionnaires before starting the therapy, after six weeks and after one year. The results show that after six weeks there was no reduction in fatigue and depression, but after one year there was a statistically significant difference between the patient group and control group: in the patient group, the overall score decreased slightly on average (reduction of fatigue and depression), in the control group, the overall score increased significantly (worsening of fatigue and depression). The greatest benefit of this study is the establishment of the Sarcoidosis Club, which meets regularly and has its place at professional events organized by the Pulmonary Clinic. Thanks to the offered group psychotherapy treatment, a group of the first members was created, to which others are gradually joining. It is obvious that there is great interest in this activity-it offers the possibility of sharing, a sense of belonging, and provides new information. Due to its formal involvement in ČOPN (Czech Civic Association against Lung Diseases), of which it became a member, it also influences health insurance companies.

BackgroundThere 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.ObjectivesThe 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.MethodsFrom 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.ResultsIn 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.ConclusionsPatients with scleroderma may have special psychological profile. MMPI-II test shows specific psychologic abnormalities of scleroderma patients. Psychiatric and psychologic ...

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BackgroundScleroderma 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.ObjectivesThe aim of study is detection of psychological profile and manifestation of depression in scleroderma patients.MethodsFrom 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.ResultsIn 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%).ConclusionsThe 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.AcknowledgementGrant support: MZ CR VES15–28659ADisclosure of Interes...