A recent study conducted on psychiatric problems associated with sclerodoma suggest that those afflicted with the condition are unusually predisposed to psychiatric problems. In one study, 30 female patients with the condition were compared with 33 control subjects, and both were given the applied psychometric instruments the Hostility and Direction of Hostility Questionnaire, the Delusions Symptoms States/Inventory/states of Anxiety and Depression and the Symptom Check List-90R. The researchers found that those with sclerodoma were unusually predisposed to increase depression, somatization, anxiety, interpersonal sensitivity, paranoid ideation, psychotic symptoms, guilt, hostility and obsessive-compulsive tendencies.
Interestingly enough, these symptoms do not appear to be solely the result of psychological reactions to having a medical condition:
“Psychiatric symptoms are frequents in patients with SSc, but pain, fatigue, disability, body changes don’t appear to explain the high prevalence of psychiatric comorbidity in SSc. Many studies founded a significant impairment in SSc patients’ QoL, and despite the undeniable correlation between physical symptoms and SSc patients’ QoL, mental health was found significantly impaired.”
Indeed, although those with rheumatoid arthritis, for example, tend to experience more pain and discomfort, those with sclerodoma seem to score more highly on measures of depression. This may be a consequence of the fact that sclerodoma, according to recent studies, may directly impact the central nervous system:
“Until a few years ago, most researchers thought that scleroderma didn’t involve CNS. Because, despite the frequency of psychiatric symptoms, neurological symptoms are rare. A functional magnetic resonance study on patients with fibromyalgia showed enhancement of activity in anterior cingulate and insular cortex during the experience of acute pain [28]: significantly, these regions of CNS are responsible of the affective processing of pain. More recent work suggests that, the focus has been shifted to understand the consequence of vascular and micro-vascular CNS involvement in SSc (hyperintense foci of variable size diffuse in white matter), and is thought to be a form of CNS vasculopathy, similar to the Systemic Lupus Erythematosus [2, 29]. Other autoimmune diseases have also cause characteristic pattern of cerebral perfusion anomalies related to mood disorders [30, 31]. Further studies will clarify the clinical correlates between psychiatric symptoms and SSc RM and SPECT imaging findings.”
