Khan Omair A, Majeed Ramsha, Kamal Kaynat, Sherazi Mahnoor, Saad Muhammad
Internal Medicine, Fauji Foundation Hospital, Rawalpindi, PAK.
Public Health, Health Services Academy, Quaid-E-Azam University, Islamabad, PAK.
Cureus. 2019 May 24;11(5):e4748. doi: 10.7759/cureus.4748.
Systemic sclerosis is an autoimmune condition that frequently affects women. It is a progressive, debilitating disease that has widespread manifestations, targeting different organs of the body with potentially fatal consequences due to lung and kidney involvement. Women with this disease mostly present with Raynaud's phenomenon along with symptoms of gastro-esophageal reflux disease (GERD). Just like any chronic debilitating condition, patients with systemic sclerosis often suffer from mental health issues that can further worsen their condition, significantly affecting their quality of life. Further research regarding the effects and severity of the disease should be encouraged for a better understanding of the illness, its diagnosis, and treatment. We present a rare case of a 55-year-old woman who presented with complaints of a major depressive episode. She was diagnosed with systemic sclerosis last year and has a history of generalized anxiety disorder. She was prescribed Mirtazapine, an antidepressant. On her follow-up after one month, she started complaining of obsessive ruminations that were causing her significant distress. She was prescribed an add-on therapy with a selective serotonin reuptake inhibitor (SSRI) antidepressant with the emphasis being placed on cognitive behavioral therapy (CBT). She reported an improvement in her obsessive symptoms as well as depression after two months.
系统性硬化症是一种常影响女性的自身免疫性疾病。它是一种进行性、使人衰弱的疾病,有广泛的临床表现,可累及身体不同器官,因肺部和肾脏受累可能导致致命后果。患有这种疾病的女性大多伴有雷诺现象以及胃食管反流病(GERD)症状。与任何慢性衰弱性疾病一样,系统性硬化症患者常患有心理健康问题,这会进一步恶化他们的病情,严重影响他们的生活质量。应鼓励对该疾病的影响和严重程度进行进一步研究,以便更好地了解该疾病及其诊断和治疗方法。我们报告一例罕见病例,一名55岁女性主诉患有重度抑郁发作。她去年被诊断出患有系统性硬化症,并有广泛性焦虑症病史。她被开了米氮平,一种抗抑郁药。在一个月后的随访中,她开始抱怨强迫性沉思给她带来极大困扰。她被加用一种选择性5-羟色胺再摄取抑制剂(SSRI)抗抑郁药进行治疗,并着重进行认知行为疗法(CBT)。两个月后,她报告强迫症状以及抑郁症状均有改善。