Psychological problems in patients with scleroderma: A controlled, prospective study

Abstract

Consecutive attenders to a rheumatology clinic specializing in the treatment of scleroderma took part in a prospective study to determine incidence and prevalence of psychological disorder and predictors of outcome over time. High scorers on the Hospital Anxiety and Depression Scale were randomized to receive brief counselling or take part in a control group. All subjects were followed up 9 months later. Prevalence and 9-month incidence of emotional distress as measured by the HAD was 21% and 17% respectively. Predictors of continued psychological distress at follow-up were the level of anxiety on the HAD and reduced mobility and quality of life as measured by the Nottingham Health Profile, at entry. Although the counselling intervention appeared to have little impact on recovery there were important limitations to the study which precluded firm conclusions about its efficacy.