Prevalence of current, 12-month and lifetime major depressive disorder among patients with systemic sclerosis

Objectives. Patients with SSc experience a range of problems affecting their quality of life, but only one small study has assessed the prevalence of major depressive disorder (MDD) in SSc. The objectives of this study were: (i) to assess the prevalence of current (30-day), 12-month and lifetime MDD in a large sample of Canadian SSc patients; and (ii) to investigate socio-demographic and disease factors associated with 12-month MDD. Methods. SSc patients were recruited from seven Canadian Scleroderma Research Group Registry sites (April 2009 to May 2012). MDD and history of a prior depression episode (major or minor) were assessed with the Composite International Diagnostic Interview. Results. Among 345 patients, prevalence of 30-day, 12-month and lifetime MDD was 3.8% (95% CI 2.2%, 6.3%; n = 13), 10.7% (95% CI 7.9%, 14.4%; n = 37) and 22.9% (95% CI 18.8%, 27.6%; n = 79), respectively. Patients with 12-month MDD had more severe gastrointestinal track involvement than patients without 12-month MDD, but there were no other significant differences on socio-demographic or disease variables. Among patients with 12-month MDD, 81.1% (95% CI 65.8%, 90.3%) reported a prior depression episode compared with 3.9% (95% CI 2.2%, 6.7%) among patients without 12-month MDD (P < 0.01). Conclusion. The prevalence of 30-day, 12-month and lifetime MDD among Canadian SSc patients is approximately twice that of the Canadian general population and somewhat higher than in arthritis. SSc patients face a range of psychosocial problems and may benefit from a broad supportive care approach.