Department of Psychiatry, McGill University, Montréal, Québec, Canada.
PLoS One. 2012;7(3):e33281. doi: 10.1371/journal.pone.0033281. Epub 2012 Mar 23.
Body image concerns are infrequently studied in systemic sclerosis (SSc), even though significant visible disfigurement is common. The objective of this study was to identify sociodemographic and disease-related correlates of dissatisfaction with appearance and social discomfort among people with SSc.
SSc patients came from the 15-center Canadian Scleroderma Research Group Registry. Sociodemographic information was based on patient self-report. Disease characteristics were obtained via physician examinations. The Brief-SWAP was used to assess dissatisfaction with appearance and social discomfort. Structural equation models were conducted with MPlus to determine the relationship of dissatisfaction with appearance and social discomfort with age, sex, education, marital status, race/ethnicity, disease duration, skin involvement, telangiectasias, skin pigmentation changes, and hand contractures.
A total of 489 SSc patients (432 female, 57 male) were included. Extent of skin involvement was significantly associated with both dissatisfaction with appearance and social discomfort (standardized regression coefficients = 0.02, p = 0.001; 0.02, p = 0.020, respectively), as was skin involvement in the face (0.18, p = 0.016; 0.23, p = 0.006, respectively). Greater social discomfort was robustly associated with younger age (-0.017, p<0.001) and upper-body telangiectasias (0.32, p = 0.021). Dissatisfaction with appearance was associated with hand contractures (0.07, p = 0.036).
This study found that dissatisfaction with appearance and social discomfort were associated with numerous disfiguring characteristics of SSc, in addition to age. These results underline that there are multiple factors contributing to body image distress in SSc, as well as the need to attend to both disease and social contexts in understanding the impact of disfigurement among patients.
尽管系统性硬化症（SSc）患者常出现明显的外观畸形，但对其身体意象的关注却很少。本研究旨在确定 SSc 患者对外貌不满和社交不适的社会人口学和疾病相关因素。
SSc 患者来自 15 个中心的加拿大硬皮病研究组注册中心。社会人口学信息基于患者的自我报告。通过医生检查获得疾病特征。使用 Brief-SWAP 评估对外貌的不满和社交不适。使用 MPlus 在结构方程模型中确定对外貌不满和社交不适与年龄、性别、教育程度、婚姻状况、种族/民族、疾病持续时间、皮肤受累、毛细血管扩张、皮肤色素变化和手部挛缩的关系。
共纳入 489 例 SSc 患者（432 名女性，57 名男性）。皮肤受累程度与对外貌不满和社交不适均显著相关（标准化回归系数分别为 0.02，p=0.001；0.02，p=0.020），面部皮肤受累也与两者均显著相关（0.18，p=0.016；0.23，p=0.006）。社交不适与年龄较小（-0.017，p<0.001）和上半身毛细血管扩张（0.32，p=0.021）显著相关。对外貌不满与手部挛缩（0.07，p=0.036）相关。
本研究发现，对外貌不满和社交不适与 SSc 的多种致畸形特征相关，除了年龄因素外。这些结果强调了导致 SSc 患者身体意象困扰的多种因素，以及在了解患者畸形影响时需要兼顾疾病和社会背景。
