Psychological adjustment to systemic sclerosis—exploring the association of disease factors, functional ability, body related attitudes and fear of negative evaluation

Abstract

The psychological impact of chronic, disabling, disfiguring and painful conditions such as systemic sclerosis (SSc) may be considerable. The purpose of the study was to examine the psychological impact of SSc and to investigate the relative importance of disease parameters, functional ability and cognitive variables specifically regarding fear of negative evaluation and negative body related attitudes in relation to psychological adjustment to the condition. Forty-nine consecutive patients with SSc completed a range of standardized psychological assessments measuring anxiety, depression, attitudes towards the body, fear of negative evaluation and specific SSc-related clinical problems experienced. Over one-third of patients sampled were classified as being probable cases for anxiety or depression. Multiple regression analysis indicated that fear of negative evaluation was the most important variable accounting for 56% of the variance in anxiety, whereas overall interference of SSc on activities made the most significant contribution (F 1,38 = 17.3, p 5 0.001) to depression. Holistic assessment of patients with SSc including psychosocial as well as clinical assessments may be pertinent in optimizing patient management.

Evidence of high levels of anxiety and depression in polymorphic light eruption and their association with clinical and demographic variables

“…Using the cut‐off suggested by Stopa and Clark 21 only four patients (2·8%) fell into the category for clinical social anxiety. The FNE scores were similar to or lower than those obtained in scleroderma (mean 14·1) 22 and atopic dermatitis (mean 18·7) 15 …”

Depression in patients with systemic sclerosis: A systematic review of the evidence

“…During the title and abstract reviews, 41 and 21 citations were excluded, respectively, leaving 21 articles for review. Thirteen of these articles were excluded, leaving a total of 8 eligible articles (Figure 1) (1, 2, 10, 19–23). All 8 articles reported data on the prevalence of clinically significant symptoms of depression.…”

Psychosocial Aspects of Scleroderma

“…32 Appearance changes in highly visible areas of the body, particularly the face and hands, are common in patients with SSc and contribute to body image distress, which in turn can be associated with symptoms of anxiety and depression. 1,4,[32][33][34][35][36] Several cross-sectional studies have reported that appearance changes of the face, including changes to the mouth, as well as hand involvement, including skin thickening, have consistently been related to body image distress, including dissatisfaction with appearance, decreased appearance selfesteem, and symptoms of anxiety and depression. [32][33][34][35][36] Other appearance changes, including telangiectasias, may also be associated with body image distress.…”