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 their occurrence in Systemic Sclerosis (SSc). Methods: 110 SSc patients and 110 controls were enrolled. Stressful events assessment included a semi-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 clinical status of patients with a very early diagnosis of Systemic Sclerosis (VEDOSS) during the first year after the diagnosis 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 year prior 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 did not, 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 may play a role in the onset and worsening of the disease