Factors influencing depression, anxiety, and quality of life in individuals with systemic sclerosis

ABSTRACT Background: In systemic sclerosis (SS), there remains limited understanding regarding its impact on quality of life, and the prevalence of depressive symptoms. Aim: To identify factors contributing to mental health outcomes in systemic sclerosis patients. Materials and Methods: The study included patients with systemic sclerosis (n = 60) and a control group matched for age and gender (n = 60). Depression and anxiety were measured with the Hamilton depression and anxiety rating scales, respectively. Quality of life was assessed using the World Health Organization Quality of Life - Brief version. Results: Among patients with SS, 50 (83.3%) exhibited the limited form of the disease, while 10 (16.7%) had the diffuse form. The mean overall modified Rodnan skin score (mRSS) was 8.6 ± 6.4. In diffuse form, mRSS was 20.8 ± 4.1 and in limited SS, mRSS was 6.2 ± 2.8. The findings revealed a significantly higher prevalence of depression (66.7%) and anxiety (76.7%) in SS patients. Rodnan score significantly correlated with severity of depression (r = 0.491, P < 0.001). Patients with diffuse SS had a poorer HRQoL than those with limited SS for physical (P = 0.023), psychological (P = 0.034), social (P = 0.041), and environmental (P = 0.049) quality of life domains. Logistic regression revealed that diffuse subtype (OR = 2.3) and higher disease duration had 1.3 times higher odds of having depression. Conclusion: SS is associated with a significant prevalence of depression and anxiety, both of which negatively impact quality of life. These findings highlight the necessity of integrating thorough mental health assessments into clinical management for SS to enhance overall health outcomes.