Anxiety levels may be slightly higher in scleroderma patients
Study cites several demographic, disease features as potential factors
People with scleroderma may have slightly elevated symptoms of anxiety compared to the general population, particularly those in specific sociodemographic subgroups, an international study reported.
Researchers found that several demographic features, such as being younger or non-white, as well as disease features, including gastrointestinal symptoms, were associated with higher anxiety levels in these patients.
“Although many factors are associated with symptoms of anxiety in individuals with [scleroderma], there are no single robust predictors to identify people with anxiety symptoms,” researchers wrote, noting that clinicians should work alongside patients to identify and address some of these anxiety-related factors.
The study, “Anxiety symptoms and associated factors in the scleroderma patient-centered intervention network (SPIN) cohort: a cross-sectional study,” was published in Rheumatology.
Prevalence of anxiety among scleroderma patients is unknown
Scleroderma is a rare immune-mediated disease marked by inflammation and scar tissue formation, or fibrosis, that can affect multiple organs. Characteristic symptoms include patches of thick and hardened skin. Raynaud’s phenomenon, in which cold temperatures or other triggers make the fingers and toes feel numb or tingly, is also a common symptom.
“People with [scleroderma] may experience anxiety due to its unpredictable course and fears of disease progression … or because of disfiguring appearance changes and body image concerns,” the research team wrote, noting, however, that the prevalence of anxiety among these patients is unknown.
To learn more about the prevalence of anxiety among people with scleroderma and potential factors associated with it, the researchers analyzed data from participants in the SPIN cohort. There were 2,463 participants from seven countries, mainly from the U.S. (34%), France (31%), and Canada (21%). Most (87%) were women, and their average age was 54.9 years.
Participants were asked to complete a questionnaire designed to assess anxiety symptoms occurring in the past week. On the questionnaire’s rating scale, a score of 50 corresponds to the average of a U.S. general population sample, with scores below 55 considered normal. Based on statistical estimates, changes of about 2.3 to 3.5 points may be clinically meaningful.
Younger age, being female asscoiated with greater anxiety levels
As a whole, people with scleroderma had a mean score of 52.6, indicating slightly higher-than-average anxiety levels. Although this might meet the minimum change from the average required to be clinically relevant, this overall score was still within a normal range.
At an individual level, more than half of the patients (55%) had scores falling in the normal range, with 22% having scores indicating mild anxiety, 19% having scores in the moderate anxiety range, and 4% having scores consistent with severe anxiety.
In statistical models, several demographic and disease factors were found to be associated with higher levels of anxiety. For instance, younger age, female sex, and non-white race were all associated with greater anxiety levels. Living in Canada, the U.K., or France was also tied to higher anxiety levels when compared with living in the U.S.
Having a more recent onset of symptoms (excluding Raynaud’s phenomenon), some joint problems, co-occurring Sjögren’s disease (another autoimmune condition), or gastrointestinal symptoms was also tied to higher anxiety.
Although these results suggest the possibility of higher anxiety in people with scleroderma, particularly in certain populations, further research will be needed “to better understand patterns of anxiety and potential causes and to develop interventions to target anxiety symptoms sources and support coping,” the researchers wrote.
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