Association of gastrointestinal involvement and depressive symptoms in patients with systemic sclerosis

Rheumatology (Oxford). 2011 Feb;50(2):330-4. doi: 10.1093/rheumatology/keq296. Epub 2010 Sep 30.

Abstract

Objectives: SSc-associated gastrointestinal tract involvement (SSc-GIT) is an important predictor of depressive symptoms. University of California at Los Angeles Scleroderma Clinical trial Consortium Gastrointestinal Tract 2.0 (UCLA SCTC GIT 2.0) is a 34-item valid instrument that captures GIT symptom severity and impact on quality of life. It has seven GI-specific scales and a total GIT score. The objectives were to assess: (i) whether there is an association between depressed mood with GI symptom scales as assessed by the UCLA SCTC GIT 2.0 instrument; and (ii) to explore which GI-specific symptom scales are associated with depressed mood in patients with SSc.

Methods: One hundred and fifty-two patients with SSc completed the UCLA SCTC GIT 2.0 and the Center for Epidemiologic Studies Short Depression scale (CES-D10). Patients were divided into depressed (CES-D ≥ 10) or non-depressed group (CES-D < 10) and compared using t-test or chi-square test. Multiple linear regression was used to determine associations between GI scales and depressed mood (CES-D).

Results: Study participants were 84% female, 78% Caucasian and 40% had depressed mood (CES-D10 ≥ 10). Patients with depressed mood had statistically worse GI scale scores (except fecal soilage) and worse total GIT score (P < 0.05). In the multivariable model reflux and constipation scales were independently associated with worse CES-D scores (P = 0.01-0.06)

Conclusion: SSc-GIT involvement is associated with depressed mood. Reflux and constipation scales of UCLA-SCTC GIT 2.0 were independently associated with CES-D. Future studies should assess if treatment of GIT symptoms will improve depressed mood in patients with SSc-GIT.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Constipation / complications*
  • Constipation / physiopathology
  • Depression / complications*
  • Depression / physiopathology
  • Female
  • Gastroesophageal Reflux / complications*
  • Gastroesophageal Reflux / physiopathology
  • Humans
  • Los Angeles
  • Male
  • Middle Aged
  • Quality of Life
  • Scleroderma, Systemic / complications*
  • Scleroderma, Systemic / physiopathology
  • Scleroderma, Systemic / psychology*
  • Severity of Illness Index
  • Surveys and Questionnaires