Anxiety and depression in patients with autoimmune disorders  

Hargitai R., Czirják L., Gyöngyösi Kiss E., Nagy L., Paksi E.
First author's affiliation: University of Pécs, Institute of Psychology, Pécs, Hungary

Psychiatric symptoms are common to many autoimmune disorders. Patients often will have mood disorders, anxiety, cognitive deficits, delirium, and psychosis. These symptoms may reflect the direct or indirect effect of the autoimmune disorder. The presentation aims to examine the degree of depression and anxiety in patients with autoimmune disorders. Subjects were selected on a database from the Immunology and Rheumatology Clinic of University of Pécs. During the recruitment period September 2007 to May 2008, 170 female patients who attended were asked to participate in the study. As diagnostic assessment instruments two standardized questionnaires, The Centers for epidemiological studies of depression scale (CES-D; Radloff, 1977) and the Hospital anxiety and depression scale (HADS; Zigmond and Snaith, 1983) were used to examine the degree of depression and anxiety in patients with systemic scleroderma (SSC, N = 100), with rheumatoid arthritis (RA; N = 20) and with systemic lupus erythematosus (SLE, N = 50). In age and qualification matched healthy female were used as controls (N = 100). CES-D and HADS are well suited for the population of autoimmune patients because these do not rely on somatic indices of depression, thus differentiating themselves from other depression inventories. The CES-D and HADS have high internal consistency for medical and healthy control populations. The patients with autoimmune disorders had significantly higher scoring rate for clinical anxiety (28%) and for clinical depression (49%) compared with control group (p<0.05). These results indicate that autoimmune patients often have mood disorders, which may affect their quality of life. Accurately recognizing the psychiatric component and generating a differential diagnosis is a complex task for the treating physician. Treatment of the psychiatric component to the disorder is essential.