Impact of gastrointestinal symptoms and psychological distress on quality of life in systemic sclerosis: a cross-sectional study

Background Systemic sclerosis (SSc) is a chronic autoimmune disease characterised by microvascular damage and fibrosis. Mortality in patients with SSc has significantly decreased. Consequently, patients with SSc have longer life expectancy, and health-related quality of life (HrQoL) has become more...

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Main Authors: Claudia Barber, Ariadna Aguilar, Alfredo Guillén-Del-Castillo, Luis Gerardo Alcala-Gonzalez, Claudia Codina, Antonio Marin Garcia, Carolina Malagelada, Carmen P Simeon-Aznar
Format: Article
Language:English
Published: BMJ Publishing Group 2024-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/11/e089725.full
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author Claudia Barber
Ariadna Aguilar
Alfredo Guillén-Del-Castillo
Luis Gerardo Alcala-Gonzalez
Claudia Codina
Antonio Marin Garcia
Carolina Malagelada
Carmen P Simeon-Aznar
author_facet Claudia Barber
Ariadna Aguilar
Alfredo Guillén-Del-Castillo
Luis Gerardo Alcala-Gonzalez
Claudia Codina
Antonio Marin Garcia
Carolina Malagelada
Carmen P Simeon-Aznar
author_sort Claudia Barber
collection DOAJ
description Background Systemic sclerosis (SSc) is a chronic autoimmune disease characterised by microvascular damage and fibrosis. Mortality in patients with SSc has significantly decreased. Consequently, patients with SSc have longer life expectancy, and health-related quality of life (HrQoL) has become more relevant in the comprehensive management of the disease.Objective To evaluate the impact between gastrointestinal (GI) symptom burden and psychological well-being on HrQoL in patients with SSc.Design Nested cross-sectional study conducted between January and July 2022.Participants A single-centre cohort of 166 patients with SSc, including 103 (55%) with limited cutaneous SSc, 43 (24%) with diffuse SSc and 37 (21%) with sine-sclerosis SSc.Main measures GI symptom burden was assessed using the University of California Los Angeles Scleroderma Clinical Trial Consortium gastrointestinal tract 2.0 (UCLA SCTC GIT 2.0) questionnaire, psychological well-being was measured with the Hospital Anxiety and Depression Scale (HADS), and HrQoL was evaluated using the Short Form 36 (SF-36) questionnaire. Demographic, clinical and immunological data were collected from a prospectively maintained database.Key results Patients with moderate to severe GI symptoms (UCLA SCTC GIT 2.0 score >0.5, n=95, 57%) reported decreased HrQoL in all subdomains except vitality by SF-36, and higher anxiety and depression scores by HADS (all p<0.05). The severity of GI symptom burden and depression were independently associated with a decline in the physical component of QoL (β=−0.273 and β=−0.411, respectively, p<0.01 for both). Only the severity of depression and anxiety (β=−0.482 and β=−0.213, respectively, p<0.05), but not GI symptom burden, were independently associated with a decline in the mental component of QoL.Conclusions Our data suggest that in patients with SSc, GI and psychological burden negatively influence quality of life independently, highlighting the need for a holistic approach to patient’s care.
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spelling doaj-art-b50529138cfd4a45a6a5e6c72ccbf6fb2025-08-20T02:38:49ZengBMJ Publishing GroupBMJ Open2044-60552024-11-01141110.1136/bmjopen-2024-089725Impact of gastrointestinal symptoms and psychological distress on quality of life in systemic sclerosis: a cross-sectional studyClaudia Barber0Ariadna Aguilar1Alfredo Guillén-Del-Castillo2Luis Gerardo Alcala-Gonzalez3Claudia Codina4Antonio Marin Garcia5Carolina Malagelada6Carmen P Simeon-Aznar71 Digestive System Research Unit, Vall d`Hebron University Hospital, Barcelona, Spain1 Digestive System Research Unit, Vall d`Hebron University Hospital, Barcelona, Spain2 Department of Internal Medicine, Systemic Autoimmune Diseases Unit, Vall d`Hebron University Hospital, Barcelona, Catalunya, Spain1 Digestive System Research Unit, Vall d`Hebron University Hospital, Barcelona, Spain2 Department of Internal Medicine, Systemic Autoimmune Diseases Unit, Vall d`Hebron University Hospital, Barcelona, Catalunya, Spain4 Department of Digestive Diseases, Vall d’Hebron University Hospital, Barcelona, Spain1 Digestive System Research Unit, Vall d`Hebron University Hospital, Barcelona, Spain6 Department of Medicine, Systemic Autoimmune Diseases Unit, Vall d’Hebron University Hospital, Barcelona, SpainBackground Systemic sclerosis (SSc) is a chronic autoimmune disease characterised by microvascular damage and fibrosis. Mortality in patients with SSc has significantly decreased. Consequently, patients with SSc have longer life expectancy, and health-related quality of life (HrQoL) has become more relevant in the comprehensive management of the disease.Objective To evaluate the impact between gastrointestinal (GI) symptom burden and psychological well-being on HrQoL in patients with SSc.Design Nested cross-sectional study conducted between January and July 2022.Participants A single-centre cohort of 166 patients with SSc, including 103 (55%) with limited cutaneous SSc, 43 (24%) with diffuse SSc and 37 (21%) with sine-sclerosis SSc.Main measures GI symptom burden was assessed using the University of California Los Angeles Scleroderma Clinical Trial Consortium gastrointestinal tract 2.0 (UCLA SCTC GIT 2.0) questionnaire, psychological well-being was measured with the Hospital Anxiety and Depression Scale (HADS), and HrQoL was evaluated using the Short Form 36 (SF-36) questionnaire. Demographic, clinical and immunological data were collected from a prospectively maintained database.Key results Patients with moderate to severe GI symptoms (UCLA SCTC GIT 2.0 score >0.5, n=95, 57%) reported decreased HrQoL in all subdomains except vitality by SF-36, and higher anxiety and depression scores by HADS (all p<0.05). The severity of GI symptom burden and depression were independently associated with a decline in the physical component of QoL (β=−0.273 and β=−0.411, respectively, p<0.01 for both). Only the severity of depression and anxiety (β=−0.482 and β=−0.213, respectively, p<0.05), but not GI symptom burden, were independently associated with a decline in the mental component of QoL.Conclusions Our data suggest that in patients with SSc, GI and psychological burden negatively influence quality of life independently, highlighting the need for a holistic approach to patient’s care.https://bmjopen.bmj.com/content/14/11/e089725.full
spellingShingle Claudia Barber
Ariadna Aguilar
Alfredo Guillén-Del-Castillo
Luis Gerardo Alcala-Gonzalez
Claudia Codina
Antonio Marin Garcia
Carolina Malagelada
Carmen P Simeon-Aznar
Impact of gastrointestinal symptoms and psychological distress on quality of life in systemic sclerosis: a cross-sectional study
BMJ Open
title Impact of gastrointestinal symptoms and psychological distress on quality of life in systemic sclerosis: a cross-sectional study
title_full Impact of gastrointestinal symptoms and psychological distress on quality of life in systemic sclerosis: a cross-sectional study
title_fullStr Impact of gastrointestinal symptoms and psychological distress on quality of life in systemic sclerosis: a cross-sectional study
title_full_unstemmed Impact of gastrointestinal symptoms and psychological distress on quality of life in systemic sclerosis: a cross-sectional study
title_short Impact of gastrointestinal symptoms and psychological distress on quality of life in systemic sclerosis: a cross-sectional study
title_sort impact of gastrointestinal symptoms and psychological distress on quality of life in systemic sclerosis a cross sectional study
url https://bmjopen.bmj.com/content/14/11/e089725.full
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