PMID- 35365580 OWN - NLM STAT- MEDLINE DCOM- 20221025 LR - 20230930 IS - 1499-2752 (Electronic) IS - 0315-162X (Print) IS - 0315-162X (Linking) VI - 49 IP - 9 DP - 2022 Sep TI - The Association of Illness-related Uncertainty With Mental Health in Systemic Autoimmune Rheumatic Diseases. PG - 1058-1066 LID - 10.3899/jrheum.211084 [doi] AB - OBJECTIVE: Patients with systemic autoimmune rheumatic diseases (SARDs) face illness-related uncertainty, but little is known about the psychological profiles and psychosocial and health needs associated with uncertainty among adults with SARDs. METHODS: Patients from the Massachusetts General Hospital with antineutrophil cytoplasmic antibody-associated vasculitis (AAV), IgG4-related disease (IgG4-RD), and systemic sclerosis (SSc) completed the Mishel Uncertainty in Illness Scale, 8-item Patient Health Questionnaire depression scale, 7-item General Anxiety Disorder scale, Sickness Impact Profile, and a survey of psychosocial needs. The associations of uncertainty and self-reported needs with depression, anxiety, and sickness impact were assessed. RESULTS: One hundred thirty-two patients with AAV (n = 41, 31%), IgG4-RD (n = 61, 46%), or SSc (n = 30, 23%) participated. The mean age was 64 years, 52% were female, and 83% were White. Greater illness-related uncertainty was positively correlated with higher levels of depression (r = 0.43, P < 0.001), anxiety (r = 0.33, P < 0.001), and sickness impact (r = 0.28, P = 0.001). We observed variations in these measures across SARDs, such that uncertainty was more strongly associated with depression and sickness impact in AAV or SSc compared to IgG4-RD. The primary needs that patients endorsed were services for managing physical symptoms (53%), self-care (37%), and emotional concerns (24%), with greater needs strongly associated with greater illness-related uncertainty. CONCLUSION: Among patients with SARDs, illness-related uncertainty is correlated with levels of depression, anxiety, and sickness impact, as well as psychosocial needs. Findings also implicate the need for targeted interventions to address uncertainty and needs among subgroups of patients with different illness profiles. CI - Copyright (c) 2022 by the Journal of Rheumatology. FAU - Wallace, Zachary S AU - Wallace ZS AUID- ORCID: 0000-0003-4708-7038 AD - Z.S. Wallace, MD, MSc, F.V. Castelino, MD, H.K. Choi, MD, DrPH, C. Perugino, DO, J.H. Stone, MD, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Mongan Institute, and Harvard Medical School. FAU - Cook, Claire AU - Cook C AD - C. Cook, MPH, X. Fu, MS, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Mongan Institute. FAU - Finkelstein-Fox, Lucy AU - Finkelstein-Fox L AD - L. Finkelstein-Fox, PhD, Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School. FAU - Fu, Xiaoqing AU - Fu X AD - C. Cook, MPH, X. Fu, MS, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Mongan Institute. FAU - Castelino, Flavia V AU - Castelino FV AUID- ORCID: 0000-0001-9862-0299 AD - Z.S. Wallace, MD, MSc, F.V. Castelino, MD, H.K. Choi, MD, DrPH, C. Perugino, DO, J.H. Stone, MD, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Mongan Institute, and Harvard Medical School. FAU - Choi, Hyon K AU - Choi HK AD - Z.S. Wallace, MD, MSc, F.V. Castelino, MD, H.K. Choi, MD, DrPH, C. Perugino, DO, J.H. Stone, MD, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Mongan Institute, and Harvard Medical School. FAU - Perugino, Cory AU - Perugino C AD - Z.S. Wallace, MD, MSc, F.V. Castelino, MD, H.K. Choi, MD, DrPH, C. Perugino, DO, J.H. Stone, MD, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Mongan Institute, and Harvard Medical School. FAU - Stone, John H AU - Stone JH AUID- ORCID: 0000-0001-6588-9435 AD - Z.S. Wallace, MD, MSc, F.V. Castelino, MD, H.K. Choi, MD, DrPH, C. Perugino, DO, J.H. Stone, MD, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Mongan Institute, and Harvard Medical School. FAU - Park, Elyse R AU - Park ER AD - E.R. Park, PhD, D.L. Hall, PhD, Department of Psychiatry, Massachusetts General Hospital, and Mongan Institute, and Harvard Medical School, Boston, Massachusetts, USA. FAU - Hall, Daniel L AU - Hall DL AD - E.R. Park, PhD, D.L. Hall, PhD, Department of Psychiatry, Massachusetts General Hospital, and Mongan Institute, and Harvard Medical School, Boston, Massachusetts, USA. hall@mgh.harvard.edu. LA - eng GR - K23 AR073334/AR/NIAMS NIH HHS/United States GR - T32 CA092203/CA/NCI NIH HHS/United States GR - K08 AR079615/AR/NIAMS NIH HHS/United States GR - K23 AT010157/AT/NCCIH NIH HHS/United States GR - L30 AR070520/AR/NIAMS NIH HHS/United States GR - R03 AR078938/AR/NIAMS NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20220401 PL - Canada TA - J Rheumatol JT - The Journal of rheumatology JID - 7501984 RN - 0 (Antibodies, Antineutrophil Cytoplasmic) SB - IM CIN - J Rheumatol. 2022 Sep;49(9):977-979. PMID: 35649548 MH - Adult MH - Humans MH - Female MH - Middle Aged MH - Male MH - Uncertainty MH - Mental Health MH - *Immunoglobulin G4-Related Disease MH - Antibodies, Antineutrophil Cytoplasmic MH - *Rheumatic Diseases MH - Depression/psychology PMC - PMC9525460 MID - NIHMS1814259 OTO - NOTNLM OT - autoimmune diseases OT - mental health OT - uncertainty EDAT- 2022/04/03 06:00 MHDA- 2022/10/26 06:00 PMCR- 2023/03/01 CRDT- 2022/04/02 05:25 PHST- 2022/03/20 00:00 [accepted] PHST- 2022/04/03 06:00 [pubmed] PHST- 2022/10/26 06:00 [medline] PHST- 2022/04/02 05:25 [entrez] PHST- 2023/03/01 00:00 [pmc-release] AID - jrheum.211084 [pii] AID - 10.3899/jrheum.211084 [doi] PST - ppublish SO - J Rheumatol. 2022 Sep;49(9):1058-1066. doi: 10.3899/jrheum.211084. Epub 2022 Apr 1.