Illness-Related Uncertainty Affects Mental Health Among Patients With SARDs

For patients with systemic autoimmune rheumatic diseases (SARDs), uncertainty related to their illness correlates to levels of depression, anxiety, sickness impact, and psychosocial needs.

Researchers used the Mishel Uncertainty in Illness Scale, Patient Health Questionnaire Depression Scale, General Anxiety Disorder, Sickness Impact Profile, and a survey of psychosocial needs to determine the association between uncertainty and self-reported needs with depression, anxiety, and sickness impact. Patients from Massachusetts General Hospital with ANCA-associated vasculitis (AAV), IgG4-related disease (IgG4-RD), or systemic sclerosis (SSc) were included.

Of 132 total patients, 44 had AAV (31%), 61 had IgG4-RD (46%), and 30 had SSc (23%). There was a positive correlation found between greater illness-related uncertainty and higher levels of depression, anxiety, and sickness impact. Uncertainty was more strongly associated with depression and sickness impact in patients with AAV or SSc as compared to IgG4-RD. Patients emphasized the need for services for managing physical symptoms, self-care, and emotional concerns. Greater needs were strongly associated with greater illness-related uncertainty.

Findings also suggest a need for targeted interventions to address uncertainty and the specific needs among subgroups of patients with different illness profiles.

—Allison Casey

Reference:
Wallace Z, Cook C, Finkelstein-Fox L, et al. The association of illness-related uncertainty with mental health in systemic autoimmune rheumatic diseases. J Rheumatol. Published online: April 2022. DOI: 10.3899/jrheum.211084.