A 38-Year-Old Woman with Elevated Muscle Enzymes, Raynaud’s Phenomenon, and Positive Anti-Topoisomerase I Antibody: Is She Depressed?

Abstract

Living with a chronic medical condition, such as systemic sclerosis (SSc), can negatively affect quality of life and psychological well-being. There is little research on outcomes important for quality of life in SSc, which poses significant challenges to addressing the psychosocial needs of people living with SSc. A recently published consensus statement highlighted important patient-reported outcomes associated with quality of life and well-being in SSc, including depression, fatigue, pain, pruritus (itching), body image distress, and sexual dysfunction. Given the wide range of problems and concerns faced by individuals with SSc, a broad approach to care, rather than an approach that focuses on a single disorder, such as depression, is recommended. Efforts are currently underway to develop strategies that focus on the behavioral and psychosocial aspects of SSc; however, in the meantime, models and approaches from fields such as psycho-oncology can be applied to support people living with SSc. For instance, care providers should be educated regarding problems faced by patients, and their supporters should facilitate discussions of these problems and should help patients in accessing self-help material. Rheumatologists and care providers should also develop relationships with competent mental health care professionals, in order to provide focused interventions and specialized care for patients in need.