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

Authors

  • Brett D. Thombs,

    Corresponding author
    1. Sir Mortimer B. Davis Jewish General Hospital and McGill University, Montreal, Quebec, Canada
    • SMBD-Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, Quebec H3T 1E4, Canada
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  • Suzanne S. Taillefer,

    1. Sir Mortimer B. Davis Jewish General Hospital and McGill University, Montreal, Quebec, Canada
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    • Dr. Baron is the director and Dr. Taillefer is the research coordinator of the Canadian Scleroderma Research Group, which receives grant funding from the Canadian Institutes of Health, the Cure Scleroderma Foundation, the Scleroderma Society of Canada, the Ontario Arthritis Society, Actelion Pharmaceuticals, and Pfizer Pharmaceuticals. However, none of these organizations had any role in this study

  • Marie Hudson,

    1. Sir Mortimer B. Davis Jewish General Hospital and McGill University, Montreal, Quebec, Canada
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  • Murray Baron

    1. Sir Mortimer B. Davis Jewish General Hospital and McGill University, Montreal, Quebec, Canada
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    • Dr. Baron is the director and Dr. Taillefer is the research coordinator of the Canadian Scleroderma Research Group, which receives grant funding from the Canadian Institutes of Health, the Cure Scleroderma Foundation, the Scleroderma Society of Canada, the Ontario Arthritis Society, Actelion Pharmaceuticals, and Pfizer Pharmaceuticals. However, none of these organizations had any role in this study


Abstract

Objective

To assess the prevalence, course, and predictors of depression in patients with systemic sclerosis (SSc).

Methods

We conducted a comprehensive search in November 2006 of MEDLINE, PsycINFO, and CINAHL databases to identify original research studies published in any language that used a structured interview or validated questionnaire to assess major depressive disorder or clinically significant symptoms of depression in patients with SSc. The search was augmented by hand searching 26 selected journals through December 2006 and references from identified articles and reviews. Studies were excluded if only an abstract was provided or if depression was not measured by a validated method.

Results

No studies used a structured clinical interview to assess the prevalence of major depressive disorder. The prevalence of clinically significant depressive symptoms was 51–65% based on 2 studies that used a Beck Depression Inventory (BDI) score ≥10 and 46–56% based on 2 studies that used a BDI score ≥11. These rates and those reported in 4 other studies that used different assessment tools (36–43%) were consistently high compared with other medical patient groups assessed with the same instruments and cutoffs. Methodologic issues limited the ability to draw strong conclusions from studies of predictors.

Conclusion

Symptoms of depression are common among patients with SSc. The high rates reported across studies suggest that routine screening is recommended. There is a need for studies that examine depression at different time points from the diagnosis of SSc and that systematically investigate factors associated with high levels of depressive symptoms.

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