979 – Stress factors and structure of mental disorders in sjögren's syndrome

Abstract

Introduction The primary Sjogren's Syndrome (SS) - a chronic, systemic autoimmune disease, characterized by lymphocytic infiltration of endocrine glands, functional impairment of the salivary and lachrymal glands, which has some common pathogenic links with stress-related mental disorders (MD). Objectives To evaluate the occurrence rate/severity of MD and the influence of stress factors in SS patients. Methods 50 inpatient women (mean age 46+13.16 yrs) suffering SS were enrolled in the study. MD were diagnosed in accordance with ICD-10 criteria. The severity of depression, anxiety and stress load were measured with MADRS, HAM-A and PSS. Results MD were diagnosed in 42 (84%) of SS patients: depressive episode (mild/moderate; single/recurrent, n=9;18%); dysthymia (n=9;18%); generalized anxiety disorder (n=7;14%); adjustment disorder (n=8;16%); schizotypal disorder (n=9;18%). Mean severity levels of anxiety, depression and stress were 16.5+6.5; 17.2+7.9 and 16.9+6.0 accordingly. The acute stress factors and reactions were preceded the SS symptoms in most cases (n= 27, 54%). MD had the significant precipitating chronic stress factors in 36 (72%) patients. The adverse experience in childhood (parental deprivation mostly) had 32 (64%) of SS patients (recurrent events - 48%). Conclusion The study revealed high occurrence rate of MD, precipitating stress factors and childhood adverse experience in SS patients. The results support the stress-diathesis model of mental disorders in patients suffering rheumatic disease.