Abstract

Background:Resilience is the ability to react positively to stressful life events, a multidimensional feature that varies in relation to context, time, age, sex, culture and personal experience, appearing among the most important traits in patients suffering from rheumatic diseases1. Several studies focus on patients with RA and SLE and the role of resilience in the respective clinical manifestations, as well as in the development of anxiety and depression2,3. Conversely, the data available regarding patients with primary Sjögren’s Syndrome (pSS) are limited.Objectives:To assess, in women with pSS (classified according to the criteria of Vitali et al.4), the relationship between resilience and anxiety, depression, health, fatigue, physical activity and quality of life in relation to disease activity and duration and in consideration of demographic, job and cultural characteristics.Methods:74 female patients with pSS afferent to the dedicated clinic of the University Hospital Policlinico Umberto I of Rome were recruited. Resilience was assessed by administering the Italian validated version of the Resilience Scale (RS-14)5consisting of 14 items, each of which is assigned a score from 1 to 7, with a range from 14 to 98. Higher scores relate to greater resilience. ESSDAI (EULAR Sjögren’s syndrome disease activity index), ESSPRI (EULAR Sjogren’s Syndrome Patient Reported Index), SSDDI (Sjogren’s Syndrome Disease Damage Index) were assessed and EuroQol / GH EQ VAS (visual analogue scale), HADS (Hospital Anxiety and Depression Scale), SF-12 (Short-form 12 health survey), FAS (Fatigue Assesment Scale), IPAQ (International Physical Activity Questionnaire), FACIT-F (Functional Assessment of Chronic Illness Therapy – Fatigue) questionnaires were submitted. Educational qualifications and job were also considered. The statistical analysis was carried out by means of Spearman’s correlation.Results:No relationship was found between resilience, systemic disease activity, disease duration, patient-reported symptoms and damage. Furthermore, no apparent link was found between socio-demographic characteristics, employment and resilience. Conversely, an inverse relationship was found between resilience and mood disorders (p=0.0379), with greater resilience associated with a better perception of quality of life (p=0.0232) and general health (p=0.0002), mainly mental (p=0.0001) than physical (p=0.0035), as well as less fatigue (p=0.0079) and more phyisically active lifestyle (p=0.0012)Conclusion:For the first time, the role of resilience in women with pSS in relation to their disease and other individual parameters was assessed. The most resilient patients are less depressed and show better perception of their health. Greater resilience tends to correlate with less anxiety, physical and mental fatigue and a more active lyfestile, while there was no relation between resilience value, active disease and socio-demographic features.

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