BackgroundThe Health Assessment Questionnaire (HAQ) is an instrument administered to patients to self-report functional status originally in rheumatoid arthritis (RA). In Argentina, it has been translated and validated for RA in 2004. For diffuse SSc, HAQ has been associated to morbidity and mortality.ObjectivesTo adapt S-HAQ into Spanish and to assess its validity in SSc patients in Argentina.MethodsS-HAQ was translated following a forward-backward translation procedure of the original English version, and transcultural adaptation was performed by a comprehension test reaching the final Spanish version. SSc patients that fulfilled ACR 80 criteria and early Systemic Sclerosis according to Le Roy and Medsger criteria were included. Patients with overlap were excluded. Cronbach's alpha and item-item item-total correlations were used to assess internal consistency. Construction validity was analyzed through factor analysis with Varimax rotation. Continuous variables were compared by t-test, Mann-Whitney or Kruskal-Wallis test, and categorical variables by chi-square or Fisher's test. A value of p<0.05 was considered significant.Resultsl9An adapted Argentine-Spanish version of S-HAQ was developed. One hundred patients were surveyed; 84% were female, mean age 54±12.8 years and disease duration 8.8±9.1 years. Limited SSc was more frequent (63%), followed by diffuse SSc (36%). Serologically, 89% were ANA positive, 27% had anti Scl 70 and 41% had anti centromere antibodies. Median Rodnan score (mRSS) was 9.8 (0–40.5) and median activity measured by EUSTAR was 1.25 (0–6). Median S-HAQ was 0.62 (0–2.5), Cronbach's alpha 0.89, and when removing questions one by one the coefficient decreased. Median VAS (visual analogue scale) was 0.57 (0–2.8). Factor analysis identified two factors for the S-HAQ: factor 1: dressing (0.61), arising (0.68), reach (0.63), and personal hygiene (0.70); factor 2: eating (0.68), grip (0.72), walking (0.49), usual activities (0.62). For questions, three factors were identified through VAS: factor 1: overall disease severity (0.63) and gastro-intestinal symptoms (0.57); factor 2: Raynaud's (0.66), digital ulcers (0.56); factor 3: respiratory symptoms (0.43). There was a statistically significant association between higher values of S-HAQ and higher values of mRSS (1.1±0.74 vs. 0.64±0.5 p=0.002) and also with seropositivity for anti-Scl 70 (p=0.003). Higher values of total VAS were associated to female gender (0.75±0.5 vs. 0.49±0.71, p=0.01). There was a significant association between S-HAQ and MEDSGER (p=0.04) and EUSTAR (p=0.03) scores; likewise, between VAS and MEDSGER (p=0.00) and EUSTAR (p=0.00) scores.ConclusionsA Spanish version of S-HAQ was developed, showing an acceptable reliability and validity.Disclosure of InterestNone declared

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BackgroundEstimated prevalence of neuropsychiatric symptoms in SLE is among 17 to 71%1. Depressive symptoms are around 54%1,2. Fatigue is frequently referred, predicts high morbidity and may be influenced by lifestyle and individual psychological characteristics1.ObjectivesTo evaluate the prevalence of depressive symptoms and its association with demographics and clinical variables in patients with SLE. To determine the predictive value of FACIT for fatigue in SLE vs controls.MethodsObservational, retrospective case- control design. Patients ≥18 years old with SLE (ACR 97) were consecutively evaluated in our centre from January to July 2015. We analyzed age, disease duration, clinical manifestations, antibodies profile, SLEDAI (≥4 scored as active) and SLICC. We recorded familiar psychiatric diseases, educational and socioeconomic level (Graffar Scale), employment and marital status. Beck II and FACIT (IV version) questionnaires were used for evaluate depression and fatigue respectively. We tested two cut points for fatigue:<22 and<40 to determine sensitivity/specificity for this tool in SLE patients vs controls3. Continues data were compared using t Student and Mann Whitney. Categorical data: chi-square or Fisher's exact test by SPSS version 20.0. To predic fatigue we calculated the area under the curve by Receiver Operating Characteristic (ROC). Statistical significant= p<0.05.Results77 SLE and 100 controls, all female. SLE vs control group: Mean of age ys: 34 (19–49)vs 38 (19–60). Prevalence of depression: 52% (44/77) vs 29% (29/100) (p<0.05). Prevalence of fatigue (FACIT<40): 42% (33/77) and 36% (36/100) (p>0.05). Mean disease duration (months) 48 (24–114). Socio-demographic characteristics, SLICC/SLEDAI, clinical and serological manifestations were not correlated with major depression p>0.05. FACIT: Median value: 31 (range 22–40) SLE group. FACIT<22 total SLE: 12/77 (15%) and FACIT<40: 33/77 (42%). Cut points FACIT SLE vs controls: <22: 15% (12/77) vs 1% (1/100) (p<0.05), 30% sensitivity/100% specificity, 100% PPV and 57% NPV. AUC FACIT <22: 0.65 (0.65–0.77). FACIT<40 in SLE vs controls: 42% (33/77) vs 26% (26/100) (p<0.05), 69% sensitivity and 84% specificity, 82% PPV and 70% NPV. AUC FACIT<40: 0.75 (0.64–0.87).ConclusionsPrevalence of depression was high in our cohort and similar to previously reported1. Our patients showed low levels of SLEDAI/SLICC. There was not relation between activity levels and baseline damage with the presence of depression4. FACIT IV scale was a good independent predictor of fatigue in SLE patients with or without depression vs controls.References L Palagini M et al Depression and systemic lupus erythematosus: a systematic review. Lupus 2013.Hugo FJ et al DSM-III-R classification of psychiatric symptoms in systemic lupus erythematosus. Psychosomatics 1996.Lai JS et al Validation of the Functional Assessment of Chronic Illness Therapy-Fatigue Scale in Patients with Moderately to Severely Active Systemic Lupus Erythematosus, Participating in a Clinical Trial Journal of Rheumatology 2...