Stressful life events at the onset and during the evolution of systemic sclerosis

Objective: Stressful life events, such as Childhood Adverse Events (CAE) and Recent Stressful Events(RSE) may play a role in the pathogenesis of autoimmune disorders. The present study investigated theiroccurrence in Systemic Sclerosis (SSc).Methods: 110 SSc patients and 110 controls were enrolled. Stressful events assessment included asemi-structured interview and the Childhood Experience of Care and Abuse Questionnaire (CECA-Q).A normative evaluation of RSE was made by means of the Paykel’s scoring of life events. The clinicalstatus of patients with a very early diagnosis of Systemic Sclerosis (VEDOSS) during the first year after thediagnosis was evaluated in order to detect patients with a significant clinical worsening.Results: All investigated CAE were more frequently reported in SSc patients compared to controls,although with a significant difference only for the events “loss of mother” (p<0.05) and “sexual abuse”(p<0.05). SSc patients reported higher occurrence of at least one RSE (p<0.01), number of RSE (p<0.01),and stress load (mean total Paykel’s score) (p<0.01) in the year prior to the diagnosis compared to the yearprior to the interview for controls. This was particularly true for severe and independent RSE (p<0.001).VEDOSS subjects who worsened during the first year after the diagnosis, compared to those who didnot, reported a higher impact of severe and independent RSE in the same year (p<0.05).Conclusions: CAE may represent potential predisposing factors for SSc, while the occurrence of RSE mayplay a role in the onset and worsening of the disease