Determinants of disability, quality of life and depression in dermatological patients with systemic scleroderma

Müller, H.V.; Rehberger, Philipp; Günther, Claudia; Schmitt, Jochen

doi:10.1111/j.1365-2133.2011.10624.x

Cited by 35 publications

(23 citation statements)

References 29 publications

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“…Depressive symptoms were found to be strongly associated with the pain VAS and particularly, HAQ scores; these indexes, more than the others, measure pain and disability (also deriving from other symptoms such as Raynaud's phenomenon or gastrointestinal symptoms) from the subjective perspective of patients: depressive symptomatology could be both a consequence and a cause of increased perception of pain and disability. This finding, then, contributes to the concept of circularity in the relationship between depression and physical illness, also supported by recent studies . The role of pain and disability as risk factors for depression also found statistical confirmation from the linear regression, outlining that depressive symptoms get worse as disability and pain increase.…”

Section: Discussionsupporting

confidence: 81%

“…This finding, then, contributes to the concept of circularity in the relationship between depression and physical illness, 36 also supported by recent studies. 29,37 The role of pain and disability as risk factors for depression also found statistical confirmation from the linear regression, outlining that depressive symptoms get worse as disability and pain increase. While performing the analysis of BDI sub-score variations, positive significant correlation was found between both sub-scores and the HAQ score, as with the total BDI score, but not with the VAS score, which only correlated with the somatic BDI sub-scale.…”

Section: Discussionmentioning

confidence: 74%

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Correlation of articular involvement, skin disfigurement and unemployment with depressive symptoms in patients with systemic sclerosis: a hospital sample

et al. 2013

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 74%

Correlation of articular involvement, skin disfigurement and unemployment with depressive symptoms in patients with systemic sclerosis: a hospital sample

et al. 2013

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“…This is also the case for patients with SSc, which is an autoimmune disease characterized by thickening of the skin as a result of fibrosis, as well as involvement of multiple internal organs, most commonly the lungs, gastrointestinal tract and heart [15]. In SSc, the Center for Epidemiologic Studies Depression Scale (CES-D) [16] has been used to assess depressive symptoms in English [17]–[20], French [19], [20], Dutch [21], and German [22]. The CES-D was originally developed in the USA to measure depressive symptomatology in the general population [16].…”

Section: Introductionmentioning

confidence: 99%

Cross-Language Measurement Equivalence of the Center for Epidemiologic Studies Depression (CES-D) Scale in Systemic Sclerosis: A Comparison of Canadian and Dutch Patients

et al. 2013

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ObjectivesIncreasingly, medical research involves patients who complete outcomes in different languages. This occurs in countries with more than one common language, such as Canada (French/English) or the United States (Spanish/English), as well as in international multi-centre collaborations, which are utilized frequently in rare diseases such as systemic sclerosis (SSc). In order to pool or compare outcomes, instruments should be measurement equivalent (invariant) across cultural or linguistic groups. This study provides an example of how to assess cross-language measurement equivalence by comparing the Center for Epidemiologic Studies Depression (CES-D) scale between English-speaking Canadian and Dutch SSc patients.MethodsThe CES-D was completed by 922 English-speaking Canadian and 213 Dutch SSc patients. Confirmatory factor analysis (CFA) was used to assess the factor structure in both samples. The Multiple-Indicator Multiple-Cause (MIMIC) model was utilized to assess the amount of differential item functioning (DIF).ResultsA two-factor model (positive and negative affect) showed excellent fit in both samples. Statistically significant, but small-magnitude, DIF was found for 3 of 20 items on the CES-D. The English-speaking Canadian sample endorsed more feeling-related symptoms, whereas the Dutch sample endorsed more somatic/retarded activity symptoms. The overall estimate in depression scores between English and Dutch was not influenced substantively by DIF.ConclusionsCES-D scores from English-speaking Canadian and Dutch SSc patients can be compared and pooled without concern that measurement differences may substantively influence results. The importance of assessing cross-language measurement equivalence in rheumatology studies prior to pooling outcomes obtained in different languages should be emphasized.

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“…The list of skin diseases causing CLCI can be enlarged considerably, but hard data are generally lacking. A high psychosomatic morbidity has been documented in patients with scleroderma by terms of disability, decreased QoL, depression and musculoskeletal pain [35,36]. Disfiguring diseases with low physical morbidity such as vitiligo or alopecia may cause CLCI as may diseases which cause direct impairment, such as ulceration and others.…”

Section: Clci In Other Skin Diseasesmentioning

confidence: 99%

Cumulative Life Course Impairment in Other Chronic or Recurrent Dermatologic Diseases

Ibler

Jemec²

2013

Dermatological Diseases and Cumulative Life Course Impairment

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Skin diseases are visible, and identifying abnormal skin generally does not require specialist knowledge. Dermatology is therefore a ripe field for studies of cumulative life course impairment, because of the many diseases that affect not only the patients, but also their psychosocial interaction with others. Dermatological patients are visibly sick. The stigma associated with visible as well as hidden skin diseases is considerable and may have a major negative impact on the life course of patients. Stigma and psychosocial relations are however not the only sources of impairment for patients with dermatological diseases. Hand eczema is a prototypical example of a skin disease that causes life course impairment not only due to stigmatization, but also to a major loss of function. The impairment therefore occurs through several mechanisms increasing the potential impact of hand eczema on patients. The list of skin diseases where an assessment of cumulative life course impairment is relevant can be enlarged considerably. Diseases with functional impairment such as, e.g. scleroderma, diseases with prominent subjective symptoms such as acne or hidradenitis, and diseases with limited physical impairment but massive psychosocial impairment in specific communities such as vitiligo, are all suitable for further studies. Life course studies are particularly suitable for skin diseases due to their often chronic recurrent course, low mortality and their psychosocial aspects. The development of a stronger empirical framework is welcomed, and may lead to considerable benefits for patients.

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Determinants of disability, quality of life and depression in dermatological patients with systemic scleroderma

Abstract: The high psychosomatic morbidity in our sample of consecutive patients with SSc calls for the investigation of interdisciplinary models of care.

Cited by 35 publications

References 29 publications

Correlation of articular involvement, skin disfigurement and unemployment with depressive symptoms in patients with systemic sclerosis: a hospital sample

Correlation of articular involvement, skin disfigurement and unemployment with depressive symptoms in patients with systemic sclerosis: a hospital sample

Cross-Language Measurement Equivalence of the Center for Epidemiologic Studies Depression (CES-D) Scale in Systemic Sclerosis: A Comparison of Canadian and Dutch Patients

Cumulative Life Course Impairment in Other Chronic or Recurrent Dermatologic Diseases

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