Clinical features and personality traits associated with psychological distress in systemic sclerosis patients

Objective: The aim of the present study was to identify certain clinical parameters and personality characteristics associated with various forms of psychopathology in systemic sclerosis (SSc) patients. Methods: Fifty-six SSc patients participated in the study, and 74 healthy participants served as controls. A wide range of clinical information was collected, and the following self-report instruments were used: General Health Questionnaire, Symptom Distress Checklist-90-R, Defense Style Questionnaire, Sense of Coherence (SOC) Scale, and Hostility and Direction of Hostility Questionnaire. Results: The odds of being assessed with a psychiatric diagnosis upon interview were 4.5 times greater among SSc patients compared with controls. Disease duration and lower rates of SOC were found to be associated with elevated symptoms of general psychological distress. Elevated symptoms of depression were strongly associated with esophageal involvement, hostility, and defense style used. Elevated symptoms of anxiety were mainly associated with arthritis-related painful conditions and SOC, while psychotic-like symptoms were only associated with age and a specific personality structure. Conclusions: SSc patients experience elevated symptoms of psychological distress. Several clinical parameters are associated with distress, but the role of various personality traits could not be disregarded. Early psychiatric assessment and intervention could prevent psychological distress in SSc patients. (c) 2007 Elsevier Inc. All rights reserved.